Gold caused skin disease

Hi all,

Can anyone respond to this question I received? best Charles

   Has anyone ever heard of a goldsmith contracting a skin
   disease called Lichen Planus? It can be a side effect from
   ingesting gold medicinally. My Dermatologist was curious
   if any other jewelers have had this. Ayala Naphtali
   Brooklyn

Dear Lewton, I am awfully suspicious of this query because it comes
from a person who might be complicit with a person on the internet
who purports to be an expert on the subject of lichen planus…and
, who is also the only medical person who suggests that lichen
planus is precipitated by ingestion of gold. My wife is affected by a
condition that has been attributed to lichen planus, but the
dermatologists have been want to ascribe a causitive factor. I would
gladly accept the diagnosis, but I would also be very suspect of the
simplistic suggestion that a very inert element might be the
cause…especially when the source of the causitive factor is
culturally related ! Ron at Mills Gem, Los Osos, Ca.

Charles, Ron, and others interested in this topic,

Such reputable sources as the American Academy of Family Physicians,
University of Virginia Hospital Center, and University of
Pennsylvania Hospital do affiliate SOME Lichen Planus cases with the
ingestion of gold, such as that used to treat rheumatoid arthritis.
I’m not sure who Ron is referring to, but well-respected and
peer-reviewed medical journals routinely cite gold as one of the
causal agents in development of lichen planus.

Specifically, the disorder is believed to be associated with an
allergic or immune system reaction to potent allergens, particularly
medications, dyes, chemicals, and metals. It is a disease that is
rarely seen in children, which supports the belief that a long-term
exposure to an allergen may be a contributing factor. Figures I’ve
seen say that about 1% of lichen planus cases are linked to chemical,
metal, or medication reactions – the other 99% are of other origins
(inherited, Hepatitis C-related, stress-related).

Interestingly, some of the other chemicals that are associated with
it include common antibiotics, arsenic, iodides, quinacrine,
quinidine, and antimony. Some of these you’ll likely recognize as
being used in the jewelry/metals industry, or as common ingredients
in coloring products (quinicrine in particular is used in artistic
oil paints).

So to answer Charles’ original question, I don’t personally know of
any jewelers who have developed lichen planus attributed to their
workplace ingestion of gold. But, given the association of the
disorder with the type of substances we use, it would not be outside
the realm of possibility for it to happen, particularly if the
jeweler were working with gold dust that could be inhaled.

Karen Goeller
kgoeller at nolimitations.com
http://www.nolimitations.com

Charles, i found this and it seems like gold causes a rash “Like
Lichen Planus”

DRUGS THAT CAN CAUSE A LICHEN PLANUS-LIKE RASH 
Phenytoin 
Oral contraceptives 
Gold 
Isoniazide 
Hydrochlorothiazide (HCTZ Diuretics) 
Atabrine (Antimalarials) 
Quinidine 
Lasix

More on Lichen Planus

Lichen planus is a stable condition - the severity and distribution
of the disease rarely changes after the first two months. While there
are many theories to explain lichen planus, many dermatologists
believe it can be classified as an autoimmune disease. This means
that white blood cells, which usually fight germs, begin to attack
the normal parts of the skin, mucous membranes, hair and nails.

Aaron A Tracy

DRUGS THAT CAN CAUSE A LICHEN PLANUS-LIKE RASH Phenytoin Oral
contraceptives Gold 

I believe that lichen planus can be caused by gold only when the
gold is ingested, as in certain treatments for rheumatoid arthritis.

All, This morning I received a letter from an Orchidian who chastised
me for suggesting that Charles Lewton Brain might be complicit with
a doctor who was suggesting that lichen planus may often be caused
by gold. In reality, now that I have had time to think about it,
what I was suggesting was that the person who had queried CLB about
the potential for gold causing this disease may have been complicit
with the doctor who had made the claim on the web. The reason that I
am skeptical about this connection is that the doctor on the web was
strongly suggesting that gold caused lichen planus and the he ( the
doctor ) might be able to successfully treat it ( intensively,
holistically and over a long period of time !) I might mention that
others have suggested that this condition normally disappears on its
own after a two year period.

My position with regard to environmentally caused disease is that
any of us jewelers who have been in the business for any period of
time might well have died a long time ago when one takes all the
warnings seriously. After all, is there any other occupation that
offers such a wide variety of potentially lethal chemical and/or
medical exposures as ours ? I have been breathing ammonia,
hydrochloric acid, sulfuric acid, abrasive particles , nitric acid,
polishing particularates, silica dust, cyanide fumes, asbestos,
fluorides, cadmium, a plethora of solvents, acetylene, soldering
fumes, acrylic acid fumes ( wax burnouts) abalone dust, metallic
dust, etc. etc. etc.) I marvel that I am still alive after thirty
five years of this exposure ! And oh! lets not forget customer
bacterial and viral sharing…the ones that come out of the
customer’s mouth after he or she sucks on their finger to get the
ring off and then hands it to you. And, of course, the cruddy
watches with their micro-organic zoos ! Yuck ! Is it any wonder
that I am skeptical about over simplified cause/effect explanations
and cures for jeweler health problems ? Ron at Mills Gem, Los Osos,
CA.

I don’t know anything about lichen planus, but this thread aroused my
curiosity. In this age of the web, it is so simple to just type it
into the search box, and hit “search”. Anyway - a couple of sites,
one being www.dermadoctor.com, talk about a “pseudo-lichen” caused by
the drugs people have mentioned, one being gold. And that it
gradually goes away after the drug is removed.

 I have been breathing ammonia, hydrochloric acid, sulfuric acid,
abrasive particles , nitric acid, polishing particularates, silica
dust, cyanide fumes, asbestos, fluorides, cadmium, a plethora of
solvents, acetylene, soldering fumes, acrylic acid fumes ( wax
burnouts) abalone dust, metallic dust, etc. etc. etc.) I marvel
that I am still alive after thirty five years of this exposure !"

Ron, This is as exactly as sensible as pointing to your 85 years old
uncle who has been smoking all his life and who is in good health and
to conclude from this that smoking does not cause a myriad of
diseases, including the most lethal ones. It just isn’t true: you
won’t breath abrasive particles, cyanide fumes, soldering fumes,
acrylic (wax!) fumes, metal dust and silica without harming yourself
and the fact that you might be in good health doesn’t prove anything.
One needs an epidemological survey for that but I can’t find any
which deals specifically with jewelers. I have been reading about wax
fumes though, and will comment on it here in a couple of weeks. Best,
Will

    Ron, This is as exactly as sensible as pointing to your 85
years old uncle who has been smoking all his life and who is in
good health and to conclude from this that smoking does not cause a
myriad of diseases, including the most lethal ones. 

Will, I was going to reply with the same analogy (I’m probably not
the only one), but thank you.

Since I’ve obviously stopped lurking, I want to share 2 things Chris
Hentz taught me about safety. He doesn’t support what you might call
the “worst case school” and I never remember him wearing a mask
(those unbearable things), but he always recommends the following:

  1. Keep a small air filter on your bench, directly behind and at the
    level of your work. Keep your face in front of, not above your work,
    and run the filter whenever you’re soldering or creating dust. (And
    keep the filter clean!)

  2. Keep your pickle pot in a separate area–preferably even a
    separate room (like a bathroom, with a ventilation fan). Chris says
    some people think he’s crazy to carry stuff back and forth, but he
    believes it’s worth it.

Since Chris strikes me as a very optimistic (and wonderful!) person,
I have taken this advice to heart (even though I do, of course,
ending up filing without ventilation–or a mask). If you’re out
there, Chris, thank you!

Lisa in Benicia