Generalized Arginia

Abstract

A brief review of literature on the problem of argyria is presented. Hyperpigmentation of the skin in 10-20% of cases has an iatrogenic cause. Hyperpigmentation of the skin can form on the background of taking non-steroidal anti-inflammatory drugs, amiodarone, cytostatics, antimalarials, etc. Systemic deposition of silver in various organs and tissues is known as generalized argyria. The disease is caused by the prolonged use of compounds containing silver (lapis pencil, silver nitrate, etc.). Clinically, generalized arginia is characterized by the gradual appearance of ashy-bluish coloration of the skin of open areas of the body (face, neck) and nail plates of the phalanges of the hands. The period from the moment of the beginning of reception of preparations of silver and before occurrence of the first dermatological changes varies on the average from 1 year to 5 years. Generalized argiria is a rare disease. This is due to the limited use of silver drugs in clinical practice, as well as the improvement of technological processes in pharmacological production. The patient’s own observation with generalized arginia formed against the background of the long-term administration of the drug Argovit-S, whose silver content is 0.75-0.85 mg/ml, is analyzed. The patient took the drug alone as a food supplement for 25 years. The diagnosis of generalized arginia is verified clinically, but is confirmed necessarily in the course of histological examination. It is shown that argyria is not only the iatrogenic cause of skin hyperpigmentation, but a serious risk factor for the manifestation and progression of liver cirrhosis. Patients with generalized arginia should undergo a comprehensive examination in order to verify the serious pathology of internal organs.

Hypothetical Mechanism of Skin Argyria

“…1. Skin argyria is caused by the appearance in the surface layers of the skin, mainly in the dermis, of highly dispersed submicron particles of metallic silver [30,[38][39][40]53,54]. 2.…”

“…2. Silver particles are predominantly located near the mouth and in the area of the sweat gland membranes [39]. This indicates that the delivery of silver compounds (from which metallic silver particles are formed) directly to the skin occurs along with sweat through the perspiration system.…”

“…The mechanism of the appearance and development of drug-induced skin argyria is unknown. Many doctors treat skin argyria as an incurable disease with an unclear pathogenesis that is considered a serious risk factor for the manifestation and progression of various pathologies; skin argyria toxicity is also being actively discussed [34][35][36][37][38][39]. Nowadays, laser therapies are considered to be the most effective because they enable the almost complete removal of argyria pigment [40,41].…”

“…Nevertheless, a logical question arises: why did people taking silver formulations not stop taking them even after the first signs of skin argyria appeared? A critical analysis of cases with skin argyria showed that these people had health problems even before taking silver [38,39]. They tried to solve them, turning to conventional medicine, but it was without success.…”