title: [Chronic mercury poisoning following topical application of skin bleachers (author's transl)].
abstract: In two female patients chronic mercurialism following topical application of skin bleachers for the treatment of freckles was diagnosed. Over 20 to 25 years 3 to 10% mercurial ointments were applied twice daily. Recurrent attacks of headache, dyspnoea and abdominal colic-like cramps had lead repeatedly to emergency hospitalisations, multiple medical check-ups and surgical exploratory procedures. The diagnosis of mercurialism was made clinically because of a slate-grayish skin hyperpigmentation in the presence of freckles, and the drug-history. Metallic deposits in facial biopsies were demonstrated by electron microscopy. On admission 15.4 microgram% and 5.0 microgram % total Hg respectively were found in the two patients (normal values up to 2.0 microgram %). Following D-penicillamine treatment the mercury excretion via the urine could be elevated up to 25 microgram %. Neither the slate-gray facial discoloration nor the neurasthenic complaints were affected by this therapeutic trial. In one patient, a maculo-papular drug-induced skin rash to D-penicillamine developed. Persistent unsolved neurological complaints and cramp-like abdominal pains should remind that percutaneous mercury intoxication through intact skin following skin bleachers is still possible today.
mesh_terms: D000328:Adult; D003358:Cosmetics / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007911:Lentigo / Q000188:drug therapy; D008630:Mercury Poisoning / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D009824:Ointments; D010396:Penicillamine / Q000627:therapeutic use; D012867:Skin / Q000473:pathology
chemical_list: D003358:Cosmetics; D009824:Ointments; D010396:Penicillamine
vernacular_title: Chronische Quecksilbervergiftung durch quecksilberpräzipitathaltige Bleichmittel.