Lasers trigger pigmentation from past gold therapy

Short-pulse lasers triggered chrysiasis more than 30 years after treatment in 2 patients with rheumatoid arthritis.

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Two patients developed laser-induced chrysiasis after receiving gold salt therapy for rheumatoid arthritis decades earlier.
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Both patients showed improvement in pigmentation after treatment with intense pulsed light and trichloroacetic acid peels.
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Histopathologic findings revealed dermal metallic deposits consistent with chrysiasis, characterized by blue-gray pigmentation.
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The mechanism of laser-induced chrysiasis may involve fragmentation of gold particles and alteration of light scattering.
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A history of gold salt therapy should be considered before short- or ultrashort-pulse laser procedures.

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