Pink disease

Acrodynia
Classification and external resources
Specialty	emergency medicine
ICD-10	T56.1
ICD-9-CM	985.0
DiseasesDB	8057
eMedicine	emerg/237 emerg/813 derm/592 neuro/617 ped/1461
MeSH	D000170
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Acrodynia is a condition of pain and dusky pink discoloration in the hands and feet most often seen in children chronically exposed to heavy metals, especially mercury.

The word acrodynia is derived from the Greek, where ακρος means end or and οδυνη means pain. As such, it might be (erroneously) used to indicate that a patient has pain in the hands or feet. However, acrodynia is a disease rather than a symptom. The condition is known by a large number of other names including pink disease, hydrargyria, mercurialism, erythredema, erythredema polyneuropathy, Bilderbeck's, Selter's, Swift's and Swift-Feer disease.

Besides peripheral neuropathy (presenting as paresthesia or itching, burning or pain) and discoloration, swelling (edema) and desquamation may occur.

Since mercury blocks the degradation pathway of catecholamines, epinephrine excess causes profuse sweating (diaphora), tachycardia, salivation and elevated blood pressure. Mercury is suggested to inactivate S-adenosyl-methionine, which is necessary for catecholamine catabolism by catechol-o-methyl transferase.

Affected children may show red cheeks and nose, red (erythematous) lips, loss of hair, teeth, and nails, transient rashes, hypotonia and photophobia. Other symptoms may include kidney dysfunction (e.g. Fanconi syndrome) or neuropsychiatric symptoms (emotional lability, memory impairment, insomnia).

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