Pigmentación exógena por nitrato de plata: aspectos dermatológicos y toxicológicos, a propósito de un caso / Exogenous pigmentation by silver nitrate: Dermatological and toxicological aspects, case report

Resumen | La pigmentación exógena por nitrato de plata es una enfermedad poco frecuente, cuyas manifestaciones clínicas pueden aparecer años después del contacto, lo que en ocasiones dificulta su diagnóstico. Se caracteriza por la presencia de máculas o placas azul-grisáceas en la piel o las mucosas de la zona de contacto que, en ocasiones, son muy similares a las lesiones melanocíticas y al melanoma, sus principales diagnósticos diferenciales. Se reporta el caso de un paciente de Medellín, Colombia, con antecedentes familiares de melanoma y presencia de estas lesiones en todo el cuerpo.

Abstract | Exogenous pigmentation by silver nitrate is a rare disease whose clinical manifestations appear even years after the contact, making its diagnosis difficult on occasions. It is characterized by the presence of blue-gray macules or plaques on the skin or mucosa in the contact area, sometimes very similar to melanocytic lesions and melanoma, which constitute the main differential diagnosis. We report the case of a male patient from Medellín, Colombia, with a family history of melanoma and the presence of these lesions throughout his body.

Localized Cutaneous Argyria Mimicking Blue Nevus after Wearing Earrings

Localized cutaneous argyria is a rare condition in which the skin changes into blue-grey spots due to the absorption of silver. The lesions need to be differentiated from other pigmentary disorders and require radiographic and histological examination for more accurate diagnosis. Scanning electron microscopy and energy dispersive x-ray spectroscopy can be a confirmatory tool in the evaluation of silver elements in biopsy tissue. This report shows the localized cutaneous argyria in earlobe of a 21-year-old woman who wears silver earrings for 10 years.

A case of generalized argyria presenting with muscle weakness

BACKGROUND: Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness. CASE PRESENTATION: A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids. CONCLUSIONS: Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.

Argiria generalizada secundaria a sulfadiazina de plata tópica / Generalized argyria secondary to topical silver sulfadiazine

La argiria es la intoxicación por plata, generalmente secundaria a medicamentos o a una enfermedad profesional. Se deposita tanto en piel como en órganos internos, otorgandoa los tegumentos una coloración gris azulada denominada cerulodermia. Esto plantea el principal diagnóstico diferencial con cianosis. Se presenta el caso de una paciente de 50 años de edad, que durante un período de 10 años aplicó sulfadiazina de plata tópica en úlceras de miembros inferiores. La absorción sistémica de este metal determinó la aparición progresiva del cuadro...

Argyria an unrecognized cause of cutaneous pigmentation in Indian patients: A case series and review of the literature.

Argyria is an uncommon grey-blue pigmentation of skin and mucous membranes caused by prolonged silver exposure. The impetus behind this review is our experience with cases of generalized argyria resulting from a uniquely Indian socio-cultural practice and belief that it is under reported. Our objective is to increase the awareness for this esoteric entity through a review of the pertinent literature and to highlight clinical and histological features using our four well worked-up cases as examples.

Argyria - Case report / Argiria - Relato de caso

A 70-year-old male rural worker was referred to our clinic with widespread grey pigmentation of the skin and nails. The condition had been asymptomatic for its entire duration (5 years). He reported past intranasal application of 10% Silver Vitellinate. A skin biopsy was performed and histology corroborated the clinical diagnosis of Argyria. This case represents a currently rare dermatological curiosity. Although silver colloids and salts have been withdrawn and/or banned by some drug surveillance agencies, they continue to be freely sold and unregulated as food supplements and as ingredients in alternative medicines, thereby risking the emergence of new cases of silver poisoning.

Um homem de 70 anos, trabalhador rural, foi referenciado à nossa consulta por dermatose assintomática, com 5 anos de evolução, caracterizada pela pigmentação acinzentada generalizada da pele, mais evidente em áreas fotoexpostas, e das lâminas ungueais. Relatava no passado o uso prolongado de Vitelinato de Prata a 10%, por via nasal. Foi efetuado exame histológico de biopsia cutânea que corroborou o diagnóstico clínico de Argiria. O caso representa uma curiosidade dermatológica, atualmente rara. Apesar de abandonados e/ou proibidos por algumas instituições de farmacovigilância, a prata coloidal e sais de prata continuam a ser comercializados como suplementos alimentares, como parte de medicinas alternativas e sem regulação, podendo fazer ressurgir os casos associados à toxicidade pela prata.

Argyria mimicking a blue nevis: dermoscopy features / Argyria imitando um nevo azul: características dermatoscópicas

Argyria is a rare disease caused by prolonged skin contact with silver. Localized cases have been described regarding the use of topical medications, and trauma with objects containing this metal such as acupuncture needles and jewelry. Clinically, a macule or a patch, round or oval, appears in the infected area, with a characteristic bluey-gray color. To our knowledge this is the first time that this clinical condition has been described through the use of dermoscopy.

A argíria é uma doença rara, causada pelo contato prolongado da pele com prata. Foram descritos casos localizados relacionados ao uso de medicamentos tópicos e traumas com objetos que contem esse metal, como agulhas de acupuntura e jóias, por exemplo. Clinicamente, aparecem máculas ou manchas redondas ou ovais na área afetada, com uma característica cor azul-acinzentada. Até onde sabemos esta é a primeira vez que este quadro clínico foi descrito através da dermatoscopia.

Medical Concern for Colloidal Silver Supplementation: Argyria of the Nail and Face

No abstract available.

Medical Concern for Colloidal Silver Supplementation: Argyria of the Nail and Face

No abstract available.

Argyria Accompanied by Normal Pressure Hydrocephalus

A 54-year-old man ingesting silver solution over 4 years presented with cognitive impairment and progressive gait disturbance. He had diffuse gray pigmentation on his face and fingertips, suggesting argyria. Brain magnetic resonance imaging (MRI) revealed hydrocephalus and high concentration of silver ion is in blood. This is the first case occuring hydrocephalus associated with the neurotoxicity of silver.

An Effective Modality for Argyria Treatment: Q-Switched 1,064-nm Nd:YAG Laser

No abstract available.

Argirose ocular e do sistema lacrimal excretor: relato de caso / Eye's and excretory lacrimal apparatus' argyrosis: case report

No período de março a novembro de 2001, foi diagnosticado um caso de argirose ocular baseando-se na história clínica, no exame biomicroscópico e histopatologia das estruturas oculares. No exame biomicoscópio, observou-se depósitos de pigmentos pardos no estroma corneano e conjuntiva. Na biópsia da conjuntiva, cristalino, canalículo lacrimal superior e saco lacrimal foram encontrados depósitos de prata.

From March to November 2001, a case of eye's argyrosis was diagnosed based on clinical history, eye's biomicroscopy and histopathology. In the biomicroscopy exam, there were gray deposits of pigments in corneal stroma and conjunctiva. In the incisional biopsy of conjuctiva, lens, upper lacrimal canaliculi and lacrimal sac deposits of silver were found.

A Case of Argyria Following Colloidal Silver Ingestion

Argyria is a rare cutaneous discoloration caused by the intake of silver or various compounds containing silver. We report a case of argyria in a 73-year-old male following ingestion of colloidal silver as an alternative medicine over 5 years. He had a diffuse, slate gray discoloration of his face and hands. A biopsy specimen from the face revealed brown-black extracellular granules in the upper dermis and between collagen bundles. We also found silver particles in the mucous of the colon. The ingestion of colloidal silver appears to be increasing among patients using alternative health practices. We report this case to bring people's attention to the problems associated with the ingestion of colloidal silver.

A Case of Argyria / 대한피부과학회지

Argyria is a rare skin discoloration caused by the deposition of silver granules in the skin. We report a case of argyria occurring in a 46-year-old woman due to ingestion of colloidal silver solution over 2 years. She had a diffuse, slate gray discoloration on her face and hands. The biopsy specimen from the face revealed melanin hyperpigmentation in the epidermal basal layer. Numerous, round, tiny brown-black granules were deposited in the basement membrane surrounding eccrine glands. Silver solution is being advertised as a cure for a variety of diseases and is commercially available as a 'food supplement'. This case report highlights the potential risk of adverse effects following the use of food supplements.

A Case of Generalized Argyria Caused by Ingestion of Silver Solution / 대한피부과학회지

Argyria is a rare skin discoloration caused by silver deposition. We report a case of generalized argyria caused by ingestion of silver solution in a 63-year-old man. He had diffuse slate gray discoloration of sun-exposed skin, prominent face, neck and V of the chest. The histopathologic findings showed brown black granules deposited in the basement membrane zone of eccrine glands, pilosebaceous units, arteriolar wall and dermal elastic fibers.

A Case of Argyria from Silver in Cellular Phone Case Manufacture / 대한산업의학회지

BACKGROUND: Skin contact with, and the breathing in of air containing silver compounds can occur in the workplace. Occupational exposure to silver and its compounds is mainly via airborne dust, metal fumes, and mists of solutions containing silver compounds. Argyria results from increased serum silver levels and the deposition of silver-containing particles in the dermis and mucous membranes. The author reports a patient with generalized argyria, who worked on the manufacture of cellular phone cases. CASE REPORT: The patient was a 30 year-old male, with extensive blue-gray discoloration of the whole body, especially sun-exposed area, of 3 years duration. He had been exposed to silver in the processing of EMI for the past 4 years and gaskets for 1 year. EMI is the process by which the internal electromagnetic wave in cellular phone cases are shielded, and gaskets play an important role in shielding the electric clashes between electronic circuits, as well as increasing the durability of cellular phone cases to impact. EMI had been processed manually but this was changed to automatic spraying by robots in 2003. On physical examination, the patient had diffuse blue-gray discoloration of the skin, which was most prominent in the sun-exposed areas of his face, neck and V of the chest. Histopathological examination of a punch biopsy specimen from the posterior neck revealed fine, minute, round, and brown-black granules deposited in the basement membrane zone surrounding the eccrine glands. The laboratory findings were positive for hepatitis B antigen, with a serum silver concentration of 150.3 ppb. From this evidence, he was diagnosed with argyria due to silver exposure. DISCUSSION: The author reports a case of occupational systemic argyria due to inhalation exposure of silver compounds.

Occupational Generalized Argyria / 대한피부과학회지

Argyria is a rare skin discoloration caused by deposition of silver granules in the skin. Recently, argyria has become uncommon, mainly due to the avoidance of both medications containing silver and occupational exposure in the silver industry. However, the recosnition of this condition remains important. We report an interesting case of generalized argyria in a 30-year old man, employed in the mobile telephone subunits industry.

A Case of Argyria Following Excessive Silver Pill Intake / 대한피부과학회지

Argyria is a rare cause of cutaneous discoloration due to silver deposition. We report a case of argyria occurring in a 38-year-old man due to excessive silver pill intake. He had a diffuse, bluish-gray pigmentation on his face and finger nails. ICPMS (inductively coupled plasma mass spectrometry) revealed that an excess of silver was present in the patient's blood, liver and skin tissue.

A Case of Generalized Argyria Secondary to Silver Pills in a Uremic Patient on Maintenance Hemodialysis / 대한신장학회잡지

Generalized hyperpigmentation has a wide range of causes, including endocrine diseases, uremia, drugs, and heavy metals. Cutaneous pigmentation observed in 70% of uremic patients on hemodialysis. However, it is clinically difficult to define the exact cause of hyperpigmentation in chronic renal failure patients. We experienced a case of cutaneous hyperpigmentation caused by generalized argyria in chronic hemodialysis patient. A 38-year-old male patient presented with slowly progressive blue-black discoloration of skin. He had been on maintenance hemodialysis for 5 years and took sliver pills 36 g daily during 2.5 years to relieve thirst. The other source of silver exposure could not be determined. Pathologic examination of skin biopsy specimen showed focal deposits of fine, uniform, brownish granules along the basement membrane zone of hair in the dermis, which is characteristic findings of argyria. The silver deposits were also confirmed by increase in serum silver level and silver amount in liver and skin tissue. Argyria should be suspected in chronic hemodialysis patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy with quantitation of tissue silver level.

A Case of Generalized Argyria Secondary to Silver Pills in a Uremic Patient on Maintenance Hemodialysis / 대한신장학회잡지

Generalized hyperpigmentation has a wide range of causes, including endocrine diseases, uremia, drugs, and heavy metals. Cutaneous pigmentation observed in 70% of uremic patients on hemodialysis. However, it is clinically difficult to define the exact cause of hyperpigmentation in chronic renal failure patients. We experienced a case of cutaneous hyperpigmentation caused by generalized argyria in chronic hemodialysis patient. A 38-year-old male patient presented with slowly progressive blue-black discoloration of skin. He had been on maintenance hemodialysis for 5 years and took sliver pills 36 g daily during 2.5 years to relieve thirst. The other source of silver exposure could not be determined. Pathologic examination of skin biopsy specimen showed focal deposits of fine, uniform, brownish granules along the basement membrane zone of hair in the dermis, which is characteristic findings of argyria. The silver deposits were also confirmed by increase in serum silver level and silver amount in liver and skin tissue. Argyria should be suspected in chronic hemodialysis patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy with quantitation of tissue silver level.