Cutaneous amalgam tattoo in a dental professional: an unreported occupational argyria

Piña, Alicia Rumayor; Martínez, Marisol Martínez; Toral-Rizo, Víctor Hugo; Lopes, Márcio Ajudarte; Almeida, Oslei Paes de

doi:10.1111/j.1365-2133.2012.11021.x

Cited by 9 publications

(10 citation statements)

References 11 publications

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“…We have used it routinely to better characterize foreign materials in oral lesions such as amalgam tattoos, and to confirm the characteristics of calcified tissues. 32 As shown in the present case, dentinoid presents irregular dentinal tubules, and the enamel matrix was easily recognized as a reticular pattern of interwoven irregular prisms with the appearance of fish scales.…”

Section: Discussionsupporting

confidence: 73%

Pigmented Ameloblastic Fibro-odontoma

et al. 2014

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Ameloblastic fibro-odontoma (AFO) is a slow-growing, expansive, benign odontogenic tumor, composed of ameloblastic epithelium embedded in an ectomesenchymal stroma resembling dental papilla, containing hard dental tissue in variable degrees of maturation, including enamel, dentin, and sometimes cementum. AFO typically affects the posterior mandible, causing bony expansion. We report a case of pigmented AFO in a 5-year-old boy, comprising clinical and histological features illustrated by immunohistochemistry using a large panel of antibodies, polarized light microscopy and scanning electron microscopy.

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Section: Discussionsupporting

confidence: 73%

Pigmented Ameloblastic Fibro-odontoma

et al. 2014

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“…When deposited in tissues, the silver seems to form complexes with sulphur derived from cellular enzymes and is retained there in this form, whereas mercury and the other elements are gradually lost with time. [7][8][9] This can help to explain the permanency of argyria.…”

Section: Discussionmentioning

confidence: 99%

Occupational Localized Cutaneous Argyria With Pseudo-Ochronosis in a Jeweler

Georgiadou

Singh

Wagner

et al. 2021

The American Journal of Dermatopathology

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A case of localized argyria in a 36-year-old female jeweler is described who presented with 2 discrete and asymptomatic bluish-black pigmented macules on the pulp of her left middle finger. A skin biopsy from both lesions demonstrated deposition of brown/black pigmented granules along the basement membrane zone of eccrine glands, blood vessels, nerves, and the dermo-epidermal junction fully in keeping with silver deposition. In addition, there was yellow-brown deposition seen within the interstitial dermis mimicking an early form of ochronosis, so called "pseudo-ochronosis." This latter feature is rarely described in cases of argyria. Transmission electron microscopy and energy dispersive x-ray spectroscopy confirmed the presence of electron dense particles up to 150 nm in diameter and the presence of silver, respectively. On further questioning, the patient had a history of localized and chronic exposure to silver, which specifically involved holding and manipulating silver wires and rings over the left middle finger. This case highlights an unusual and rare presentation of localized argyria in a jeweler. In addition, our case showed preferential silver deposition on dermal elastic fibers which has not been previously described in the literature.

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“…This results in macular lesions or spots-clusters, confined to where the silver impregnation occurred and with coherent morphology, whose color, compared to GA’s, tends to be darker, sometimes almost black [ 8 , 73 , 81 , 82 , 83 ]. Patients most commonly present with complaints of asymptomatic lesions in a site of previous trauma, cautery with silver devices, or prolonged contact with silver-containing objects, creams, or solutions, as it occurs in the hands and forearms of silver-handling workers [ 2 , 75 , 81 , 82 , 84 , 85 , 86 , 87 ].…”

Section: Argyria Subtypesmentioning

confidence: 99%

“…Any of these findings might correspond to argyria: a slate-gray/bluish change of the complexion in sun-exposed areas, localized dark-blue lesions, eye gray/brown/dark spots or conjunctival pigmentation, or the characteristic nail changes seen in azure lunula [ 34 , 46 , 48 , 61 , 73 , 82 , 115 , 165 ]. Silver product exposition, as in oral silver consumption in a GA-suitable patient, a previous dental restoration in a patient presenting with amalgam tattoos, or acupuncture history in a patient with dispersing cutaneous LA lesions, can be highly indicative of argyria [ 5 , 53 , 86 , 89 ]. Different causes have been documented, and Table 1 compiles all major causes of argyria.…”

Section: Diagnosis Of Argyriamentioning

confidence: 99%

“…In the posterior segment of the eye, silver accumulation is speculated about, following reports of retinal pigment epithelium changes, drusenoid deposits, and dark choroids in fluorescein angiogram, but a necessary causal relationship was not yet clearly established [111,[156][157][158]. Following local contact, silver episcleral and periocular inoculation, such as in the eyelids, can also be present [23,86,[159][160][161]]. Silver's histopathological pattern of deposition will also be similar whether there's local implantation or systemic absorption, behaving as seen elsewhere in the body: settling in epithelial basement membranes and subepithelial connective tissue, predominantly extracellularly, and undergoing redox reactions that aggravate the pigmentation and stabilize the silver compounds [102,112].…”

Section: Pathophysiology Of Argyriamentioning

confidence: 99%

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Clinical and Forensic Aspects of the Different Subtypes of Argyria

Mota

Dinis-Oliveira

2021

JCM

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Argyria encompasses the different cosmetic alterations that can develop if enough silver particles deposit in a specific tissue, typically in the skin, ranging from localized dark-blue macules to a generalized slate-gray/bluish tinge following systemic absorption. This work aims to fully review the state of the art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic features of argyria. Argyria has been diagnosed in a wide range of ages, both sexes and varied ethnicities, with no known individual predisposing factors. Ultraviolet radiation with subsequence increases of melanin production aggravates the discoloration due to a reduction in the silver deposits. Physical examination and silver exposure in the anamnesis can be highly suggestive of the diagnosis, but a histopathological analysis with Energy-Dispersive X-ray Spectroscopy is required to unequivocally determine the discoloration etiology. Safe and effective treatment has only been accomplished with laser techniques, though only a few cases have been reported and with limited follow-up time. In conclusion, argyria typically has an occupational or iatrogenic etiology. It should be suspected when a patient presents with typical skin or eye lesions. A seemingly viable treatment modality, with laser technology, is finally within the horizon.

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Cutaneous amalgam tattoo in a dental professional: an unreported occupational argyria

Cited by 9 publications

References 11 publications

Pigmented Ameloblastic Fibro-odontoma

Pigmented Ameloblastic Fibro-odontoma

Occupational Localized Cutaneous Argyria With Pseudo-Ochronosis in a Jeweler

Clinical and Forensic Aspects of the Different Subtypes of Argyria

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