Localized cutaneous argyria

doi:10.1016/j.jaad.2010.05.016

Journal of the American Academy of Dermatology

Volume 65, Issue 3, September 2011, Pages 660-661

This case was presented at the American Society of Dermatopathology meeting on October 1-4, 2009, but has not been previously published.

https://doi.org/10.1016/j.jaad.2010.05.016 Get rights and content

References (4)

W.A. High et al.
Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis
J Am Acad Dermatol
(2007)
L. Robinson-Bostom et al.
Localized argyria with pseudo-ochronosis
J Am Acad Dermatol
(2002)

There are more references available in the full text version of this article.

Cited by (22)

Localized cutaneous argyria: Review of a rare clinical mimicker of melanocytic lesions
2021, Annals of Diagnostic Pathology
Citation Excerpt :
The clinical differential diagnosis of blue-gray skin is outlined in Table 1 and includes melanocytic lesions, deposition disorders, vascular lesions, exogenous material, medications, and inflammatory conditions [3,4,9,10,12,13,15,18,20,21]. There have been several reports in the literature in which localized cutaneous argyria has been clinically mistaken for melanocytic lesions, including blue nevi and metastatic melanoma [11,15,22,23] and we have seen such examples in our clinical practice as well (Fig. 1). Histologically, as shown in Fig. 2a to c, argyria is characterized by multiple small, uniform, brown-black granules, which are non-polarizable and distributed along the basement membranes of sweat glands, connective tissue sheaths of pilosebaceous units, arrector pili muscles, vessel walls, perineural tissue, and elastic fibers [4,9,10,12,13,17].
Localized cutaneous argyria is a rare cutaneous disorder that has been associated with occupational exposure, dental procedures, topical agents, acupuncture, earrings, and nasal piercings. In this paper, we review the current literature on localized cutaneous argyria, highlight its clinical and histologic diagnostic features, and then discuss the clinical and histological differential diagnoses for blue-gray skin and black dermal pigment, respectively. We also discuss the utility of ancillary techniques, such as deeper histologic levels, special stains, darkfield microscopy, and advanced micro-analytical techniques in helping diagnose localized cutaneous argyria. Furthermore, we emphasize that a thorough clinical history and astute clinico-pathologic correlation can be the most important diagnostic techniques in correctly diagnosing this rare disorder. Our review aims serve as a reminder to clinicians and pathologists of the importance of including localized cutaneous argyria in the clinical and histological differential diagnosis of pigmented lesions.
Toxicity of silver ions, metallic silver, and silver nanoparticle materials after in vivo dermal and mucosal surface exposure: A review
2018, Regulatory Toxicology and Pharmacology
Citation Excerpt :
Regarding metallic silver, one silversmith had argyria in the fingers (Kamiya et al., 2011) and another in the fingers and arm (García-Martínez et al., 2016). Localized argyria was observed in jewelry manufacturers, in skin (Robinson-Bostom et al., 2002) and eyes (Tendler et al., 2017) following the occupational handling of silver (Nagano et al., 2016) and after exposure to mirror fragments (Hristov et al., 2011). A 40-year-old woman developed argyria following the accidental imbedding of an acupuncture needle 7 years earlier (Park et al., 2018).
Silver is used in different applications that result in contact with skin and mucosal surfaces (e.g., jewelry, wound dressings, or eye drops). Intact skin poses an effective barrier against the absorption of silver. Mucosal surfaces are observed to be less effective barriers and compromised skin is often a poor barrier. Silver can deposit as particles in the human body causing a blue-gray discoloration known as argyria. Urine and feces are reported pathways of excretion. Acute human mortality has been observed following an abortion procedure involving the intrauterine administration of 7 g silver nitrate (64 mg silver/kg body weight). Localized argyria has been reported with exposure to silver ions, metallic surfaces, and nanocrystalline silver. Generalized argyria was observed with ionic and nanocrystalline silver in humans at cumulative doses in the range of 70–1500 mg silver/kg body weight. Silver is observed to have a low potential for skin irritation. Eye irritation and some cases of allergic contact dermatitis have been reported. Silver may cause genotoxicity, but additional data are required to assess its carcinogenic potential. Other reported toxicities include hepatic, renal, neurological, and hematological effects.
Diagnostic Pathology: Nonneoplastic Dermatopathology
2016, Diagnostic Pathology: Nonneoplastic Dermatopathology
Localized cutaneous argyria: A report of 2 cases
2013, Actas Dermo-Sifiliograficas
Localized Cutaneous Argyria at the Site of a Prior Melanoma Excision Confirmed by Scanning Electron Microscopy With Energy Dispersive X-ray Analysis
2024, American Journal of Dermatopathology
sQuiz your knowledge! A blue-greyish asymptomatic papule on the earlobe
2023, European Journal of Dermatology

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LetterLocalized cutaneous argyria

Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis

J Am Acad Dermatol

Localized argyria with pseudo-ochronosis

J Am Acad Dermatol

Letter
Localized cutaneous argyria