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Acrodynia Workup

  • Author: Kamila K Padlewska, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
Updated: Apr 14, 2016

Laboratory Studies

Evidence of excess mercury in the urine of affected persons has been noted. A 24-hour urine collection is recommended because urinary elimination of mercury is unpredictable and may vary from day to day or from hour to hour. Mercury values in persons with acrodynia can vary from 0-401 mcg/L. A value of less than 10 mcg/L is generally considered within reference range. Concentrations greater than 300 mcg/L are considered the threshold of toxicity, and symptoms rarely occur until mercury excretion rises to this level.

Blood evaluation is recommended, particularly for acute intoxication. Normal levels rarely exceed 15 mcg/L. Mercury levels in the plasma may be elevated for prolonged periods because of slow release from erythrocytes after oxidation.

Mercury blocks the action of catechol methyl transferase, leading to increased amounts of vanillylmandelic and homovanillic acid in urine.

Excretion of 17-ketosteroid has also been shown to be increased in these patients.

Analysis of hair strands by means of x-ray fluorescence for mercury contamination also may be considered, but the results may be falsely elevated in persons residing in environments with increased ambient atmospheric concentrations or in populations consuming methylmercury-contaminated seafood.


Histologic Findings

Hyperplastic sweat glands and nonspecific inflammation have been observed in skin biopsy specimens. Degenerative changes have been found in peripheral nerves and chromatolytic changes at the anterior horn cells of the spinal cord.

Contributor Information and Disclosures

Kamila K Padlewska, MD, PhD Professor, Warsaw Academy of Cosmetics and Health Care; Chief Executive, Cosmetic-Medical Cooperative Izis, Poland

Disclosure: Nothing to disclose.


Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Shyam Verma, MBBS, DVD, FAAD Clinical Associate Professor, Department of Dermatology, University of Virginia School of Medicine; Adjunct Associate Professor, Department of Dermatology, State University of New York at Stonybrook School of Medicine; Adjunct Associate Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Shyam Verma, MBBS, DVD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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