title: A case of generalized argyria after ingestion of colloidal silver solution.
abstract: A 58-year-old woman was referred to our hospital due to progressive skin darkening, which began 5 months previously. The patient had strikingly diffuse blue-gray discoloration of the skin, most prominent in sun-exposed areas, especially her face and hands. The oral mucosa, tongue, gums, eye conjunctiva, ears, nail beds, and trunk were also involved. Bluish-gray discoloration of all nails was aggravated by cold weather. She had ingested 1 L of colloidal silver solution daily for approximately 16 months as a traditional remedy. Her serum silver concentration was 381 ng/ml which was a very high (reference level: <15 ng/ml). Light microscopic examination of a punch biopsy specimen from her nose revealed fine, minute, round, and brown-black granules deposited in the basement membrane of hair follicular epithelium. Scanning electron microscopic examination showed electron-dense granules deposited in the intercellular space of sweat glands. Energy disperse X-ray spectrometry analysis demonstrated peaks for silver and sulfur in the dense black deposits. The ingestion of colloidal silver appears to be an increasing practice among patients using alternative health practices. All silver-containing products including colloidal silver should be labeled with a clear warning to prevent argyria, especially in alternative health practices.
authors.affiliation: Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. yanghokm@nuri.net
authors.forename: Yangho
authors.initials: Y
authors.lastname: Kim
authors.forename: Ho Seok
authors.initials: HS
authors.lastname: Suh
authors.forename: Hee Jeong
authors.initials: HJ
authors.lastname: Cha
authors.forename: Suk Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Kyoung Sook
authors.initials: KS
authors.lastname: Jeong
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Kim
mesh_terms: D000284:Administration, Oral; D001129:Argyria / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008519:Medicine, Traditional; D008875:Middle Aged; D012834:Silver / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D012834:Silver