ARGYRIA

By Gary M. White, MD


Argyria is the bluish discoloration of the skin caused by exposure to silver.

Clinical

Blue macular discoloration which may be generalized or accentuated in the sun-exposed areas, oral mucosa, conjunctiva, or nails is typical. Internal organs may be bluish. Argyria is caused by prolonged ingestion or mucosal application of silver salts.

Localized occurrence may present as a blue-green macule resembling a blue nevus. It may be secondary to trauma as occurred in a woman whose silver ring was imbedded into her skin. One year later she observed a bluish macule surrounding the scar [AD 1996;132;459]. Other accidental implantations have occurred with silver wires in silversmith and jewelry pieces from earrings [JAAD 2002;46;222]. Simply wearing silver earrings caused localized argyria in one case [BJD 1996;135;484]. Silvadene (silver sulfadiazine) applied to a postsurgical wound and area of severe contact dermatitis caused the development of argyria.

Treatment

Avoiding exposure to silver is of course key. Various lasers have been used. In one study, a patient was treated with the Q-switched 1,064 nm Nd:YAG laser (3-6 mm spot; 0.8-2 J/cm(2)). The entire face, neck, upper chest, and arms were treated over multiple sessions. This resulted in excellent clearing of the treated skin [Lasers Surg Med. 2013 Jan;45(1):15-21].

References

A silver factory worker with implantation of silver leading to argyria. Dermatology Online Journal 19(7)

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