A 42-year-old woman presented with blue lunulae in association with argyria and hypercopprecaemia. The argyria was caused by the regular ingestion of colloidal silver in water over an extended period of time. The raised copper may have contributed to the nail discolouration, and was believed to be due either to ingestion of copper-containing multivitamin tablets or as an acute-phase reactant. We believe that the ease of access to, and lack of stringent regulatory controls over, food supplements and alternative medicines may cause similar cases in the future. We therefore recommend that all patients should be routinely questioned on their use of over-the-counter preparations and alternative medicines.
We report eight individuals with localized lipoatrophy of the lateral lower leg that were seen by a single dermatologist in a 1-year period. All were asymptomatic and half had mild epidermal changes consistent with lichenification. Seven were an incidental finding during a general skin examination. All had a long-standing history of frequent leg crossing. The sites correlated with the area resting on the patella of the opposing knee. The depressions were larger on sides of leg-crossing preference. Only one had a significant rise in antinuclear antibodies, but this patient had no other clinical or serological abnormalities. This appears to be an extremely common yet previously unreported form of localized lipoatrophy.
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