Localized Argyria Caused by Silver Earrings

Abstract

A patient with silver earring backings, embedded in the ear lobes for several years, developed blue macules of localized argyria on both sides.

Generalized Argyria after Habitual Use of AgNO3

“…There have been other cases in which it was confirmed that the granules contained silver by using energy dispersive X-ray microanalysis (7)(8)(9)(10). In those cases, the electron dense granules contained silver and other ingredients such as sulfur, chloride, phophorus, aluminum, titanium, iron, mercury, and selenium.…”

“…Cases have followed the use of silver salts for the irrigation of nasal or urethral mucous membranes and the excessive use of an oral-smoking remedy containing silver acetate (2,3). Blue macules have appeared at the sites of acupuncture needles (4) and silver earring sites (9,10).…”

Localized Cutaneous Argyria

“…This condition had a peak incidence in the 19th and 20th centuries secondary to the ingestion and topical application of silver-containing compounds. 1,[6][7][8][9][10][11][12][13][14] The typical clinical presentation of localized cutaneous argyria is a permanent blue-gray macule or papule in a sunexposed area. 3 The most common risk factor is now occupational exposures including, but not limited to, mining, welding, silversmithing, antique restoration, jewelry manufacturing, and photographic development.…”

“…8,11 Microscopically, the silver deposits are more widely distributed with a predilection for dermal elastic fibers and collagen bundles. Both traumatic implantation and the resulting inflammatory response release silver salts into the surrounding tissues.…”

Localized argyria in an antique restorer

“…However, this was secondary to trauma over the overlying skin, as the lesions corresponded to puncture sites 2 . This phenomenon is well established with cases following endodontic procedures, 3 acupuncture 4 and even repeated wearing of silver earrings 5,6 . We believe that localized occupational argyria is a grossly under‐reported condition and that up to 40% of exposed individuals may develop the condition.…”