Clinical and Forensic Aspects of the Different Subtypes of Argyria.

Luís Mota,Ricardo Jorge Dinis-Oliveira

doi:10.3390/jcm10102086

Abstract

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.

Highlights

IntroductionArgyria refers to inert silver deposition in a tissue, typically the skin, resulting in characteristic blue/gray spots or a diffuse hue, and possibly darker or brownish [1,2,3,4,5,6]
Argyria refers to inert silver deposition in a tissue, typically the skin, resulting in characteristic blue/gray spots or a diffuse hue, and possibly darker or brownish [1,2,3,4,5,6].It occurs following excessive accidental voluntary cumulative silver exposure by the most varied causes
A precise cut point for silver ingested after which Generalized skin hyperpigmentation (GA) development should be expected has not been determined, for which contributes to the rarity of this occurrence and the unawareness of argyric patients regarding the silver products’ composition and their consumption magnitude [64,200,211,220,221]

Summary

Introduction

Argyria refers to inert silver deposition in a tissue, typically the skin, resulting in characteristic blue/gray spots or a diffuse hue, and possibly darker or brownish [1,2,3,4,5,6]. It occurs following excessive accidental voluntary cumulative silver exposure by the most varied causes. The state of the art concerning pathophysiology, clinical presentation, diagnosis, therapeutic modalities, and forensic features of argyria is reviewed, and the main gaps in current knowledge, where future research ought to be focused, are highlighted It is mainly a cosmetic condition whose clinical presentation will vary according to the subtype as describe below [2,3,7,8,9].

Objectives

Methods

Findings

Conclusion