Localized cutaneous argyria
Department of Pathology, The University of Colorado Health Sciences Center, Aurora, Colorado.Journal of the American Academy of Dermatology (Impact Factor: 5). 09/2011; 65(3):660-1. DOI: 10.1016/j.jaad.2010.05.016
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ABSTRACT: Argyria is an uncommon grey-blue pigmentation of skin and mucous membranes caused by prolonged silver exposure. The impetus behind this review is our experience with cases of generalized argyria resulting from a uniquely Indian socio-cultural practice and belief that it is under reported. Our objective is to increase the awareness for this esoteric entity through a review of the pertinent literature and to highlight clinical and histological features using our four well worked-up cases as examples.Indian journal of dermatology, venereology and leprology 11/2013; 79(6):805-11. DOI:10.4103/0378-6323.120735 · 1.33 Impact Factor
- British Journal of Dermatology 04/2012; DOI:10.1111/j.1365-2133.2012.11021.x · 4.10 Impact Factor
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ABSTRACT: BACKGROUND AND OBJECTIVE: Generalized argyria is a blue-gray hyperpigmentation of the skin resulting from ingestion or application of silver compounds, such as silver colloid. Case reports have noted improvement after Q-Switched Neodymium-Yttrium Aluminum Garnet laser (1,064 nm QS Nd:YAG) laser treatment to small surface areas. No reports have objectively monitored laser treatment of generalized argyria over large areas of skin, nor have long-term outcomes been evaluated. STUDY DESIGN/MATERIALS AND METHODS: An incremental treatment plan was developed for a subject suffering from argyria. A quantitative near infrared spectroscopic measurement technique was employed to non-invasively analyze tissue-pigment characteristics pre- and post-laser treatment. Post-treatment measurements were collected at weeks 1, 2, 3, and 4, and again at 1 year. RESULTS: Immediate apparent removal of pigment was observed with 1 Q-switched 1,064 nm Nd:YAG laser treatment (3-6 mm spot; 0.8-2 J/cm(2) ) per area. Entire face, neck, upper chest, and arms were treated over multiple sessions. Treatments were very painful and general anesthesia was utilized in order to treat large areas. Near-infrared spectroscopy was used to characterize and quantify the concentration of silver particles in the dermis based on the absorption features of the silver particles as well as the optical scattering effects they impart. We were able to estimate that there was, on average, 0.042 mg/ml concentration of silver prior to treatment and that these levels went below the minimum detectable limit of the instrument post-treatment. There was no recurrence of discoloration over the 1-year study period. CONCLUSION: QS 1,064 nm laser treatment of argyria is a viable method to restore normal skin pigmentation with no evidence of recurrence over study period. Quantitative spectroscopic measurements: (1) confirmed dyspigmentation was due to silver, (2) validated our clinical assessment of no recurrence up to 1-year post-treatment, and (3) indicated no collateral tissue damage with treatments. Lasers Surg. Med. © 2013 Wiley Periodicals, Inc.Lasers in Surgery and Medicine 01/2013; 45(1). DOI:10.1002/lsm.22084 · 2.61 Impact Factor
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