Ocular Argyrosis Mimicking Conjunctival Melanoma.

PURPOSE: To present a novel case of ocular argyrosis mimicking conjunctival melanoma. METHODS: A 48-year-old man who is a jewelry manufacturer presented with raised pigmented lesions in the inferior fornices of both eyes. Brown-black colored, follicle-like, masses were observed in both fornices. RESULTS: An incisional biopsy confirmed the presence of silver and the diagnosis of ocular argyrosis. CONCLUSIONS: Despite its limited negative health effects, ocular argyrosis should be considered in the differential diagnosis of conjunctival pigmented lesions because of the potential for misidentification of neoplastic growth.

Localized argyria caused by metallic silver aortic grafts: a unique adverse effect.

INTRODUCTION: Silver-coated grafts are designed to prevent vascular graft infections. Silver is a safe element but toxic effects have been reported. We describe two cases of possible localized argyria after silver graft implantation. REPORT: Two patients presented with perigraft groin collections after implantation of silver grafts. During reoperation, an ashen-grey necrotic substance was seen surrounding the grafts. The grafts were explanted and lower limb perfusion restored. Cultures were negative and both patients had uneventful recoveries. DISCUSSION: Our cases are highly suggestive of a possible unique adverse effect: a combination of localized silver toxicity and neutrophilic mediated tissue destruction.

Local argyrosis of oral mucosa or amalgam tattoo. A problem in diagnosis and treatment.

The authors, basing on three cases published by different authors in the years 1995-2003, discuss the problem of diagnosis and treatment of local gingival argyrosis and amalgam tattoo. Treatment methods carried out consisted of the following procedures free gingival graft, subepithelial connective tissue graft in a two-step procedure and subepithelial connective tissue graft without flap coverage. In the authors opinion in some cases a connective tissue graft does not need flap coverage, therefore a dual blood supply is not necessary.

Use of the gingival unit transfer in soft tissue grafting: report of three cases.

Current procedures in periodontal plastic surgery probe the limits of the copious blood supply available to the periodontal tissues. None reaches for these limits more consistently and meets with less forgiveness than soft tissue grafting for the interdental papilla and root coverage in esthetically sensitive areas. Gingiva contains the only soft tissue naturally created to survive and function interproximally and facially over avascular root surfaces. Preliminary results suggest that the supracrestal gingiva, used as a free graft for the above purposes, may have an uncommon capacity for perfusion and survival. More investigation is necessary to confirm the validity of this concept. The gingival unit transfer is introduced through three case reports that describe its use for root coverage and replacement of intact but pathologically involved or esthetically compromised papillae.

Periodontal treatment of an amalgam tattoo.

The amalgam tattoo can often result in an unsightly cosmetic appearance, especially in the maxillary anterior region. The predominant treatment for an amalgam tattoo is the free gingival graft, which also results in a poor cosmetic appearance. The authors would like to review the pathogenesis of the amalgam tattoo and present a new technique that leads to a pleasing cosmetic result.

Multifocal corneal argyrosis after an explosion injury.

PURPOSE: To document the clinical and histopathologic corneal features of a patient who developed multifocal corneal argyrosis after a chemical explosion injury with unusual involvement of the corneal stroma and keratocytes. METHODS: The corneal button was investigated by light and transmission electron microscopy and scanning electron microscopy combined with energy-dispersive x-ray microanalysis. RESULTS: Clinically, the patient showed dark discoloration of the lids, periocular skin, episclera, and conjunctiva and had multiple brown dots in the superficial layers of the cornea. Microscopic examination of the cornea showed diffuse deposition of silver particles in the epithelial basement membrane, Bowman's layer, and Descemet's membrane. In the corneal stroma, silver granules accumulated intracellularly within lysosomal structures of degenerative keratocytes and extracellularly in association with collagen fibers and cellular debris. Energy-dispersive x-ray analysis showed peaks of silver and sulfur. CONCLUSION: The toxic influence of intracellular accumulation of silver in stromal keratocytes may lead to cell damage and necrosis and result in visual impairment.

Management of diffuse tissue argyria subsequent to endodontic therapy: report of a case.

A case of severe mucogingival argyria secondary to leakage around and corrosion of silver cone root canal obturations and apical amalgam restorations is presented. Following removal of the silver points and re-treatment of the root canals, periradicular surgery was performed to remove the amalgam root-end restorations and reduce the amount of dispersed metallic particles in the subcutaneous tissues. Subsequent free gingival grafting created an esthetically pleasing and biologically acceptable result.

Clearing of corneal argyrosis by YAG laser.

A 75-year-old woman with corneal argyrosis was treated by a Q-switched Nd-YAG laser iridotomy after acute angle closure glaucoma. Each laser shot caused clearance of the argyrotic deposits anterior to the iridotomy site. The same effect was seen when a preventive iridotomy was performed in the other eye. The areas of clear cornea remained unchanged for a follow-up period of eight months.