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April 29, 1974

Gold in Arthritis

Author Affiliations

Millburn, NJ

JAMA. 1974;228(5):565. doi:10.1001/jama.1974.03230300013002

To the Editor.—  The Primer on the Rheumatic Diseases (224[suppl]:661-812, 1973) is, with justification, recommended to medical students, house staff, and practitioners as the best concise summary of rheumatic diseases.We are disturbed, therefore, to find a statement on page 733 relating to the therapy of psoriatic arthritis to the effect that "chrysotherapy... [is] not helpful and may aggravate the skin disease." This advice is not justified by clinical studies and may result in the withholding of gold from patients who would benefit from it. Six of the seven references in the Primer do not mention gold therapy. The seventh (Wright V: Psoriatic arthritis. Bull Rheum Dis 21:627, 1971) notes that "gold is not contraindicated as it has been found that no more skin reactions are experienced in psoriasis than... in rheumatoid arthritis." Three leading rheumatology tests (Hollander-McCarty, Copeman, and Boyle-Buchanan) all deny any increased incidence of skin reactions although