1064 nm Q‐switched Nd:YAG laser for the treatment of Argyria: a systematic review

Abstract

Argyria is a benign skin disease characterized by blue to slate-grey discoloration that is caused by deposition of silver granules in the skin and/or mucus membranes as a result of long-term ingestion of ionized silver solutions or exposure to airborne silver particles. The skin discoloration can be generalized or localized and is exacerbated by sunlight. The skin discoloration is usually permanent, and until recently, there has been no effective treatment for argyria. Over the past 6 years, a number of case reports and one case series have described cases of argyria that were successfully treated with a 1064 nm Q-switched (QS) neodymium-doped yttrium aluminium garnet (Nd:YAG) laser; however, a review of these studies has never been reported in the dermatologic literature. To review the use of the 1064 nm QS Nd:YAG laser for the treatment of argyria. A search of the National Library of Medicine's PubMed Database and the SCOPUS Database was performed to find articles that detailed the treatment of argyria with 1064 nm QS Nd:YAG laser. Six articles were selected for inclusion in this review. Each article was reviewed and summarized in a table. A 1064 nm QS Nd:YAG laser offers a novel and effective treatment for argyria. A systematic review of the dermatologic literature revealed a limited number of case reports and case series using this treatment. However, the results gleaned by the authors from the literature review provide important information to the clinician. For patients with argyria, a single pass of the 1064 nm QS Nd:YAG laser offers immediate, effective and sustained pigment clearing without any long-term adverse effects.

Laser treatment of hyperpigmented lesions: position statement of the European Society of Laser in Dermatology

“…Laser systems have proven effective in clearing NMD‐PD. A critical analysis of recent medical literature confirmed the effectiveness of 1064 nm QS lasers in clearing argyria . The average pulse duration selected by the majority of authors ranged from 5 to 60 nanoseconds, with a fluence varying from 0.7 to 8 J/cm 2 , and spot sizes from 2 to 8 mm.…”

“…Marked improvement was reported also using a 755‐nm Alexandrite laser with 3‐ms pulse duration, working at fluences in the range of 25–50 J/cm 2 and a spot size of 10‐mm. No clinical improvement was observed 6 months after treatment but marked pigment clearing was documented after 18 months …”

Dermoscopy of localised argyria: Apropos of five cases

“…However, Q-switched lasers have achieved good results. 6 In conclusion, the typical dermoscopic pattern of localised argyria is a bluish-black homogeneous pattern without structures and with blurred borders that has a pattern that predominates in the ridges when it affects palms.…”

Chromonychia in an Asymptomatic Vitamin Consumer

“…1,064-nm Q-switched Nd:YAG laser may be promising in cutaneous argyria, but it has not been utilized for treating azure lunulae of argyria [7,8]. We decided not to offer this treatment to our patient, as we were concerned of possible side effects.…”

“…There are no known chelating agents or other treatments for argyria [7]. 1,064-nm Q-switched Nd:YAG laser may be promising in cutaneous argyria, but it has not been utilized for treating azure lunulae of argyria [7,8].…”