Argyrie L81.8

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch

Synonym(s)

Argyria; Argyrose; Skin discoloration due to silver

History
This section has been translated automatically.

Albers 1816

Definition
This section has been translated automatically.

Slate-grey, diffuse pigmentation of skin and mucous membranes with emphasis on light-exposed areas by deposition of silver complexes (oxidation products of the primarily colourless silver complexes: photo effects as in photography) after ingestion of silver-containing drugs.

Etiopathogenesis
This section has been translated automatically.

Intake of silver-containing drugs, e.g. silver protein acetyltannate in targesin roller cures, silver compounds in throat disinfectants.

Chronic exposure to silver dust for employees in silver processing plants.

Lozenges for smoking cessation may also contain silver salts.

Silver bound to cysteine enters the skin via the bloodstream. There, a photochemical reaction takes place upon exposure to light, producing sparingly soluble Ag2S (silver sulphide) which is accumulated in the skin. (Principle of the exposed photoplate).

Localization
This section has been translated automatically.

Entire skin surface with clear emphasis on the light-exposed areas; possibly oral mucosa, nail bed, conjunctiva.

Clinical features
This section has been translated automatically.

Diffuse, bluish to slate grey, only cosmetically disturbing discoloration.

Histology
This section has been translated automatically.

  • Numerous black granules, visible only at high magnification, with affinity to elastic fibres, basal membrane, sweat and sebaceous glands. Illumination of the embedded particles in the dark field.
  • Electron microscopy: Electron density, approx. 200 nm large granules. With the help of X-ray microanalysis their high silver content can be detected.

Differential diagnosis
This section has been translated automatically.

Physiological (actinic) skin pigmentation: light as in argyrosis; the slate-grey shiny aspect of the skin discoloration is missing.

Cyanosis: blue-red discoloration; depending on the type of cyanosis, lips and mucous membranes are markedly cyanotic, usually a sign of heart failure.

Chrysiasis: brown discolouration of the skin, accentuated by light! Medication history. Clinically not distinguishable without further explanation.

Hydrargyrosis: used to be used as a bleaching agent. Its use is prohibited.

Icterus: elevation of bilirubin; yellowing of the sclerae; liver diseases (e.g. hepatitis, cirrhosis of the liver)!

Xanthoderma: Yellowing of the skin as a side effect of a mepacrin therapy (anti-epileptic drug) or a therapy with Qinacrin or Sorafenib.

Dyschromia caused by drugs such as: minocycline, amiodarone, imipramine, clofazimine, hydroxychloroquine.

Exogenous dyschromia: discoloration of the contact zones.

Therapy
This section has been translated automatically.

Causal therapy not known. After avoiding silver-containing drugs, the changes do not or only slightly decrease. Chelating agents are ineffective, see also chysiasis.

Successes with a therapy using the Nd:YAG laser and the Alexandrite laser have been reported.

Literature
This section has been translated automatically.

  1. Becher E et al (1994) Generalized argyrosis by a preparation with trace elements. Z Hautkr 69: 388-390
  2. Fisher NM et al (2003) Scar-localized argyria secondary to silver sulfadiazine cream. J Am Acad Dermatol 49: 730-732
  3. Fritsch P (1996) Metal dermatoses II. dermatologist 47: 400-409
  4. Mittag H et al (1987) On the question of argyrie. Dermatologist 38: 670-677
  5. Robinson-Bostom L et al (2002) Localized argyria with pseudo-ochronosis. J Am Acad Dermatol 46: 222-227
  6. White JM et al (2003) Severe generalized argyria secondary to ingestion of colloidal silver protein. Clin Exp Dermatol 28: 254-256

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020