Argyria

Argyria

Key Points
Causes bluish-grey to slate grey staining of the skin and mucous membranes
Caused by deposits of silver particles in the skin

Argyria is a very rare condition in which silver deposits in the skin causing silver toxicity, which prevents itself as a pigmentation shift from normal to bluish-grey to slate grey. Localized Argyria can affect a certain portion of the body, usually the eye, but is often a precursor to generalized Argyria, which can affect large portions of the body. Generalized Argyria will often begin as gray or brown staining to the gums, progressing over a period of months or years to affect large areas. Pigmentation change is most prevalent in areas of the body commonly exposed to sunlight.

Any substantial exposure to silver particles being ingested or impregnating the skin or other tissue can lead to Argyria. These exposures can include occupational exposure, medications or dietary supplements which contain silver salts or colloidal silver, or even surgical or dental procedures which employ the use of silver sutures. Severity is predicated on many factors, including the duration, dose, and method of exposure.

Differential Diagnosis (Other conditions with similar appearance)

Methemoglobinemia
Polycythemia
Addison disease

Diagnosis
Key Points
Initial diagnosis based on skin appearance
Skin biopsy must be performed to confirm diagnosis and rule out other conditions

Argyria is initially diagnosed based on appearance, then confirmed through skin biopsy. Due to its rarity, it is often misdiagnosed.

Treatment
Pigmentation is permanent
Some treatments are used to lessen Pigmentation, with varying degrees of success.

Unfortunately, the Pigmentation associated with Argyria is permanent. It is recommended that affected persons cease exposure to silver immediately upon presentation of symptoms to prevent further progress of the condition.

While some treatments are purported to alleviate Pigmentation in some areas, such as depigmentary agents, laser surgery, or use of Hydroquinone to reduce the amount of silver in the upper dermis, these treatments are largely unsuccessful.