[ARGYRIA AND LYMPHORETICULAR REACTION. (REPORT OF 2 CASES OF GENERALIZED ARGYRIA)].
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Generalized argyria in two chronic hemodialysis patients.
Silver can be absorbed through ingestion, topical administration, or inhalation. Generalized argyria results from deposition of silver in the skin, nails, mucous membranes, and internal organs and is characterized by a diffuse bluish-gray discoloration in sun-exposed areas. We report two cases of generalized argyria in patients on maintenance hemodialysis (HD) therapy for more than 15 years. They presented with diffuse hyperpigmentation of the face that was mistaken to be related to uremia and bluish-gray discoloration of all nails believed to be cyanosis. Histopathologic examination of skin biopsy specimens showed characteristic findings of argyria, which was further confirmed by radiograph microanalysis. Their serum silver levels were also elevated. No definite silver source could be determined. However, their argyria might be related to their long-term HD therapy because (1) they had been on HD therapy for more than 15 years and the discoloration appeared several years afterward, and (2) the water used for HD was not well processed in the early 1980s in TAIWAN: Argyria should be suspected in chronic HD patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy.
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Localized argyria with pseudo-ochronosis.
BACKGROUND: Localized argyria is uncommon and presents clinically as asymptomatic slate gray macules or blue macules resembling blue nevi. Its histopathologic features are usually similar to those of generalized argyria in which silver granules are found most commonly around the eccrine glands, in the walls of blood vessels, and along elastic fibers. Ochre swollen homogenized collagen bundles resembling ochronosis have not been previously described. OBJECTIVE: The purpose of this study is to report a series of 5 patients with localized argyria with the histologic feature of "pseudo-ochronosis." In one patient, biopsy was performed on 2 distinct lesions. METHODS: All patients underwent skin biopsies for light microscopy and darkfield microscopy. In two patients, the biopsy specimens were analyzed with a mass spectrophotometer; scanning electron microscopy and energy-dispersive x-ray analysis were performed. In one patient, the biopsy specimen was decolorized with 1% potassium ferricyanide in 20% sodium thiosulfate. RESULTS: All 5 patients presented with the typical clinical and histologic features of localized argyria. Ochre swollen and homogenized collagen bundles were seen in all cases. In addition, light microscopy in 4 cases revealed an ellipsoid black globule within a zone of collagen degeneration. CONCLUSION: The histologic features of localized argyria include swollen and homogenized collagen bundles resembling ochronosis, "pseudo-ochronosis," which may be more common than previously recognized.
Aged↗
Long-term use of silver containing nose-drops resulting in systemic argyria.
Generalized argyria is a silver intoxication that results in pigmentation due to deposition of silver in the skin and mucous membranes. Compared to several decades ago, argyria is now relatively rare. We report a case of generalized argyria after continous use of argyrophedrine nosedrops in the last ten years. Argyria should be taken into consideration when a patient presents with a blue-grey discoloration of the skin, particulary in areas exposed to the sun.
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Localized argyria after exposure to aerosolized solder.
GOAL: To understand localized argyria to better manage patients with the condition OBJECTIVES: Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Discuss how localized and generalized argyria differ. 2. Describe how to diagnose argyria. 3. Identify treatment options for argyria.
Aerosols↗
Two unusual cases of argyria: the application of an improved tissue processing method for X-ray microanalysis of selenium and sulphur in silver-laden granules.
Using a simplified tissue processing method for X-ray microanalysis, we have characterized the elemental composition of silver-laden granules deposited in the skin of two patients with argyria. The introduction of ethanol as a fixative and nylon mesh as a supporting grid, and the avoidance of electron staining, have facilitated the minimization of unwanted microanalytical emission peaks generated from conventional chemicals and metals, which often disturb precise clarification of elements of pathological interest in argyria. The two main X-ray microanalytical findings in this study were: (i) the consistent presence of sulphur and the inconsistent occurrence of selenium in the silver-laden granules, and (ii) successful mapping of the distribution of trace amounts of selenium present in argyria. The simplified tissue processing method could be useful in future critical X-ray microanalysis studies.
Adult↗
Scar-localized argyria secondary to silver sulfadiazine cream.
Silver sulfadiazine cream is a topical antibacterial agent that combines the antibacterial effects of both silver and sulfadiazine. Its reported cutaneous side effects include hypersensitivity reactions, allergic contact dermatitis, erythema multiforme, and systemic argyria. We report the case of a patient who had localized argyria develop in a scar after the use of silver sulfadiazine cream. In this case, the silver sulfadiazine cream was applied to and argyria developed within a postsurgical wound and area of severe contact dermatitis.
Administration, Cutaneous↗
Argyria following the use of dietary supplements containing colloidal silver protein.
The onset of argyria following the use of dietary supplements containing colloidal silver protein is presented. The patient was using a silver-containing product for cold and allergy prophylaxis. We review the past and present medicinal roles of silver and include a differential diagnosis for argyria. The hyperpigmentation of argyria is usually permanent, and it follows a sun-exposed distribution. This case report highlights the potential for toxicity following the use of dietary supplements and demonstrates the importance of physician inquiry regarding alternative medicines. Finally, we examine the limited role of the Food and Drug Administration (FDA) in regulating alternative medicines marketed as dietary supplements.
Argyria↗
Argyria.
The distinctive blue-gray discoloration that occurs in argyria is due to deposition of silver and a silver-induced increase in melanin. Argyria is pronounced in areas of sun exposure and in the lunulae of the fingernails. Skin biopsy confirms the diagnosis by demonstrating tiny brownish granules in connective tissue surrounding sebaceous glands, in perineural tissue and in arteriolar walls. Pigmentation is permanent but benign. While the incidence of argyria is declining, its recognition remains important.
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Argyria and cyanotic heart disease.
A case report in which argyria is mistaken for cyanotic heart disease is described. A discussion of argyria, a benign cosmetic condition resulting from either ingestion or the local application of silver salts or colloidal silver, is presented. It is suggested that by obtaining comprehensive drug histories, maintaining patient profiles, and through patient counseling, pharmacists are in a position to identify and advise on known cases of argyria.
Aged↗
Systemic argyria secondary to topical silver nitrate.
A case of generalized argyria secondary to topical silver nitrate use on the oral mucosa is described, and the nature and history of argyria reviewed. The patient has extreme pigmentation of her skin and abdominal viscera, as seen on physical examination, gastroduodenoscopy, and laparotomy. Her use of silver nitrate applicators was uncontrolled by her dentist and pharmacist, and the diagnosis of argyria was not made until 2 1/2 years of heavy usage had passed. Avoidance of similar cases requires the careful scrutiny of silver-containing medicinal usage by all health practitioners and pharmacists. Although the systemic distribution of silver in both elemental and ionic forms can be linked with no systemic toxicity, the resultant pigmentation can be devastating to the patient.
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Generalized argyria. Clinicopathologic features and histochemical studies.
In three cases of generalized argyria, the degree of slate-gray cutaneous discoloration varied from barely perceptible to pronounced. Deposition of silver-containing granules in and around cutaneous adnexal structures was best seen with darkfield microscopy. Histochemical studies suggested that the granules consisted of silver sulfide. Indiscriminate use of currently available silver-containing medications can result in generalized argyria.
Aged↗
Generalized argyria secondary to chewing photographic film. Report of a case.
A case report of generalized argyria found on routine examination and confirmed by history has been reviewed. The condition has been present for the last 16 years and has gone unchanged. A review of argyria is presented, and the importance of other systemic disease entities in patients with skin discoloration is mentioned.
Aged↗
Argyria secondary to ingestion of homemade silver solution.
Argyria is a rare skin disease caused by cutaneous deposition of silver granules in the skin as a result of exposure to silver substrate or ingestion of silver salt. This report describes a patient with generalized argyria caused by ingestion of homemade colloidal silver solution. The patient learned about the uses of the silver solution and its preparation at a convention for "natural medicine."
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Argyria: the intradermal "photograph," a manifestation of passive photosensitivity.
X-ray microprobe and electron microscopic study was made of the remarkable blue-black pigmentation that sunlight elicits in patients with argyria. The patient under study had developed argyria following injection of silver nitrate as a sclerosant into his varicose veins 41 years ago. Similarities are demonstrated between the darkening of the skin and the darkening of a photographic film following light exposure. In both instances, colorless silver salts and compounds present in an inert matrix (collagen versus gelatin) are reduced by incident light to black metallic silver. This passive photosensitivity reaction leads to silver tattooing of the light-exposed skin and to photographic imaging in the film.
Aged↗
Severe generalized argyria secondary to ingestion of colloidal silver protein.
Argyria is a rare cause of cutaneous discolouration caused by silver deposition. We report a case of dramatic and diffuse argyria secondary to ingestion of colloidal silver protein over a 1-year period. Stained electron microscopy with spectral analysis was used to confirm the clinical diagnosis. Silver-protein complexes are deposited in the skin and reduced to inert silver salts by sunlight in a process similar to that harnessed in photography. Our patient had obtained the silver for consumption via mail order. It had been advertised as a cure for a variety of diseases. Colloidal silver protein is commercially available as a 'food supplement', hence circumventing the strict controls placed on medicines.
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Argyria caused by an earring.
The staining of skin by silver is termed argyria and is grey-blue in colour. This may be caused by a number of mechanisms such as ingestion and direct implantation. We report an unusual case, caused by an impacted earring, where the skin discoloration was not entirely typical of argyria. This may have been due to copper impurities present in the earring. The literature on the subject is also reviewed.
Adult↗
Detection of selenium in generalized and localized argyria: report of four cases with X-ray microanalysis.
Electron microscopic and X-ray microanalytic studies were performed on four cases of argyria; one generalized and three localized. Deposition of electron dense granules was predominantly found on elastic fibers and around basal laminas of secretory portions of eccrine glands, although the amount of deposition was much less in the case of generalized argyria. In all four cases, X-ray microanalysis revealed that the depositions consisted mainly of silver, selenium, and sulfur. The importance of selenium in the detoxification of heavy metals was discussed.
Acupuncture Therapy↗