Argyria L81.8

Albers 1816

Generalized argyrosis: Slate-gray, diffuse pigmentation of skin and mucous membranes with accentuation of light-exposed areas due to deposition of silver complexes (oxidation products of the primarily colorless silver complexes: photographic-like effects) after ingestion of silver-containing drugs.

Localized argyrosis: circumscribed slate-gray discolorations, especially in the mucous membrane area, after application of preparations containing silver salts. Also after piercing!

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).

Numerous black granules visible only at high magnification with affinity to elastic fibers, basement membrane, sweat and sebaceous glands. Illumination of the embedded particles in the dark field.

Electron microscopy: electron dense, approximately 200 nm granules. X-ray microanalysis can be used to detect their high silver content.

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.

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.

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