Generalized Argyria after Habitual Use of AgNO₃

Abstract

Generalized argyria, the systemic dissemination and tissue deposition of silver-containing particles, is characterized by slate gray discoloration of skin, most pronounced in sun exposed areas. A 33-year-old woman visited our dermatologic clinic complaining of frequent oral ulceration for 10 years and generalized discoloration of her skin for 5 years. She had had her tongue painted with silver nitrate repeatedly 6 years ago for the treatment of oral ulcers. Physical examination showed slate gray discoloration of her skin, most pronounced on the face and neck. The oral mucosa, tongue, sclera, and conjunctiva also had a slightly blue-gray discoloration. Biopsy specimens from the oral mucosa and forearm revealed small brown-black granules scattered in the dermis and basal lamina of eccrine sweat glands, blood vessels, and hair follicles under the light microscope. Tiny black granules were most numerous in the basal laminae of vessels in electron microscopic observation. Energy dispersive X-ray microanalysis (EDXA) confirmed that many of the granules contained silver.

Chemical Transformations of Nanosilver in Biological Environments

“…10 is consistent with the observed fact that some argyrial cases occur in patients who have ingested silver forms that do not appear to contain particles. 33,34,100–102 Particularly relevant support for our proposed pathway is found in a recent article in this journal, 102 in which rats were orally exposed to both soluble silver or two different silver nanoparticles. The biodistribution patterns were observed to be similar for soluble and NP forms, and particles were observed in tissue even when the rats were only fed soluble (non-particulate) silver.…”

The Medicinal Applications of Imidazolium Carbene−Metal Complexes

“…Also, the use of anti-smoking tablets and gum, which contain silver acetate, have been reported to cause generalized argyria 43,44. Several reports of localized and generalized argyria surfaced after the use of topical solutions of silver nitrate45 and silver sulfadiazine cream 43. It is important to note that argyria is rarely the cause of any ill effect or death and that there are no effective treatments for removing silver deposits from the body 46.…”

Evaluation of Silver Nanoparticle Toxicity in Skin in Vivo and Keratinocytes in Vitro

“…Although argyria is most commonly reported clinically after excessive Ag ingestion, Ag deposition has been seen after treatment of burned skin with Ag sulfadiazine (Lee and Lee 1994; Marshall and Schneider 1977; Temple and Farooqi 1985). In response to argyria, but not to Ag toxicity, the National Institute for Occupational Safety and Health (2003) set a daily exposure limit for all forms of Ag at 0.01 mg/m 3 , and the U.S.…”