Azure Lunulae Due to Argyria

Argyria secondary to ingestion of homemade silver solution

“…3,6,9,16,19 Discolored nails, often present in generalized argyria, may also be the result of pseudomonal infections. 24,25 Although skin discoloration is present, argyria is generally a benign condition. 2,6,7,16,19 One study of patients with argyria reported negative effects on night vision.…”

Chromonychia in an Asymptomatic Vitamin Consumer

“…The appearance of a bluish-gray discoloration following the distal margin of the lunulae can be an early sign of argyria, along with similar discoloration of the hands and face, especially the conjunctivae [1]. The discoloration is most prominent in sun-exposed areas, as the silver compounds upregulate melanin production, and sunlight catalyzes the reduction of the colorless silver compounds in the dermis to elemental silver, which is then oxidized and bound to form the metallic silver sulfide [2].…”

“…The key to the diagnosis is the patient's stating of her long-term silver supplement use, coupled with the classic physical findings of the nails. A nail biopsy would be diagnostic, but a nail clipping would not, as the nail matrix is not affected and no nail plate changes would be seen [1]. Although azure lunulae of Wilson's disease are similar in appearance to azure lunulae of argyria [5], the average age of diagnosis of Wilson's disease is 20.4 years [6], our patient had no other findings consistent with Wilson's disease such as Kayser-Fleischer rings, organomegaly or neuropsychiatric abnormalities, and the patient's nail findings chronologically coincided following chronic ingestion of a silver solution.…”

Pigmentations of the Nails (Chromonychia)

“…Gold salts cause black‐brown colors; silver salts produce blue‐gray discolorations. Azure lunulae from deposition of silver may be the earliest sign of argyria …”