Urinary mercury in twelve cases of cutaneous mercurous chloride (calomel) exposure: Effect of sodium 2,3-dimercaptopropane-1-sulfonate (DMPS) therapy

Objective: To evaluate clinical symptoms and urinary mercury before and after chelation therapy in subjects with chronic cutaneous mercurous chloride (HgCl; calomel) exposure. Subjects: Twelve women from 19-45 years who had used a facial cream which contained HgCl (5.9%) for 2 to 10 years. Design: Twenty-four hour urine samples were collected for basal urine mercury. All the subjects received a 5-day cycle of oral sodium 2,3-dimercaptopropane-1-sulfonate (Dimaval(R) capsules 100 mg) 200 mg/d on an outpatient basis. The urine mercury excretion was monitored 24 hours after the first dose and 72 hours after the last dose in eight subjects. Result: Exanthem and tremor were detected in two of 12 subjects. The range of urine mercury was 180 to 1876 mu g/g creatinine. A significant increase in the urinary mercury excretion was observed in the first 24 hours after beginning sodium 2,3-dimercaptopropane-1-sulfonate. Conclusion: Chronic topical application of 5.9% HgCl cream was associated with clinical mercurialism in two subjects and with high urinary mercury level in all the cases. Sodium 2,3-dimercaptopropane-1-sulfonate was effective in increasing mine mercury.