Blue macules of localized argyria caused by implanted acupuncture needles. Electron microscopy and roentgenographic microanalysis of deposited metal

Silver from Polyurethane Dressing Is Delivered by Gradient to Exudate, Tissue, and Serum of Patients Undergoing Negative-Pressure Wound Treatment

“…Soluble silver is thought to be reduced to its insoluble or metallic form, which is subsequently oxidized to form complexes with sulfur and selenium, giving rise to the characteristic grayish coloration seen in individuals with this condition. 15,29,30 In histological cross sections obtained after 72 hours of treatment, the authors recognized sparse aggregations of silver (Figure, G-I) similar to those reported for argyria or the introduction of silver in the dermis. 13,14,31Y34 The authors also confirmed the presence of silver in 1 patient by energy-dispersive X-ray spectroscopy, which also showed an increase in sulfur that probably indicated the deposition of silverY sulfate complexes (Table 5).…”

Pigmented Lesions on the Ear: Answer

“…1 Alternatively, argyria may have a localized presentation, secondary to inadvertent introduction of silver from an external source into the mucocutaneous membranes through percutaneous absorption via sweat ducts or traumatic inoculation. 1,2 Localized argyria has been reported in association with acupuncture needles, [3][4][5] traditional Japanese "hari" therapy, 6 topical application of silver-containing medical or medicinal products (eg, silver sulfadiazine cream, eyedrops, wound dressings, or solutions), 1 dental procedures, 7,8 traumatic implantation of mirror fragments, 9 contact with a silver ring 10 or nose piercing, 11 and occupational exposure to silver in the context of silversmithing, 12 electroplating, 6 restoration of antiques, 13 jewelry manufacturing, or processing of photographs. 1,13,14 In the patient presented herein, silver exposure was likely associated with ear piercings.…”

“…1,13,22 The presence of silver has also been shown in other cases of localized argyria using TEM/EDS. 1,3,4,6,14,16 Other micro-analytical techniques such as mass spectrophotometry, in vivo reflectance confocal microscopy, or electron probe microanalysis have also been utilized to demonstrate silver deposition in argyria. 2,[22][23][24] In our case, TEM/EDS analysis identified high levels of selenium in addition to silver (Fig.…”

Blue skin

“…A diagnosis of argyria can be made from a skin biopsy, with histopathologic analysis demonstrating silver compounds deposited along the basement membrane surrounding sweat glands, as well as in the elastic fibers of the dermis and the fibrous sheaths surrounding pilosebaceous structures . Electron probe microanalysis as well as dark‐field microscopy can additionally be used to diagnose arygria …”