Localized chrysiasis induced by laser in a patient with rheumatoid arthritis

Chrysiasis is an uncommon permanent blue-gray discoloration occurring on the sun-exposed skin of the patients who have been exposed to gold salts. Light exposure and total amount of gold administrated have been reported to play important roles in the development of chrysiasis. We herein report a case of localized chrysiasis in a patient with rheumatoid arthritis who had received long-term parenteral chrysotherapy. Blue-gray discoloration has developed after laser treatment for her freckling and lentigenes over the treatment areas. Punch biopsy was obtained and the biopsy specimen showed light microscopic and ultrastructural characteristics of gold deposition.