Silver blue skin - Argyria - causes, symptoms and treatment

Bluish skin discoloration > Silver blue skin - Argyria

What is argyria?

The rare blue skin disorder, Argyria, is due to the presence of silver in the skin.

Argyria disease results from protracted excessive exposure or ingestion of metallic silver, silver salts and silver compounds. There are two types of argyria disease. Ingestion of silver salts and silver compounds for prolonged period causes generalized (universal) form of argyria ailment whereas continuous localized excessive contacts with silver and its compounds causes localized argyria disease, affecting only the parts of the body which are in direct contact with blue or blue grey skin discoloration.

Apart from skin, sclerae, conjunctiva, oral mucosa, tongue, other mucous membranes, nail beds, gums and internal visceral organs also may get affected with discoloration. Melis Palamar, MD et al have recorded that the content and color of the tears can be affected by argyria. A patient with bilateral black tears (melanodacryorrhea) was found to have bilateral argyrosis of the conjunctiva due to occupational inhalation of silver compounds.

Silver has a wide variety of uses as jewelry, silverware, dental fillings, antibacterial agent and light sensitive coating of photo films. There are many medical uses of compounds of silver as incorporation into wound dressings, as antiseptic applications and as disinfectants in medical appliances. There is a school of alternative medicine advocating the use of colloidal silver as a cure for many ailments like AIDS and dermatitis. However the efficacy of these colloidal compounds in medical treatment is still under dispute. Bluish skin discoloration
Image of generalized argyria [Image by Herbert Fred, Hendrik van Dijk/Images of Memorable Cases: Case 4/ http://cnx.org/content/m14962/1.3/(CC-BY 2.0)]

Argyria causes and risk factors

• Prolonged exposure to dust containing particles of this metal, as in silver mining causes argyria.
• Prolonged exposure of workers in factories manufacturing jewelry and silverware may cause this blue skin disorder.
• Dental fillings made of this metal causes argyria in some cases. Silver sutures used in surgeries were one of the causes of this blue skin disease.
• Prolonged use of medications, drugs and supplements containing silver, its compounds or colloidal silver causes this disease.
• Homemade concoctions with this metal for treating diseases may cause argyria.
• Nasal sprays, nose drops, topical applications, tattoo colors and acupuncture and piercing needles containing  compounds of this metal can cause localized argyria.
• Lee SM and Lee SH of Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea, reported a case wherein use of silver nitrate (AgNO3) to treat oral ulcers for ten years had caused generalized argyria.
• In a study in Japan it was found that habitual use of a breath freshener coated with silver had caused this disorder in some people.

Symptoms of argyria

• On prolonged exposure to silver or its salts if there is blue  or blue-grey skin discoloration, it is a clear symptom of argyria.
• Gums getting blue grey discoloration is another symptom of argyria.
• Blue discoloration of skin of the hands and face turning darker on exposure to sunlight is another symptom of argyria.
• Normally symptoms of argyria do not develop immediately. Up to 1 mg of silver is found in human body. Symptoms of this blue discoloration usually occurs when there is accumulation of four grams. In some people the symptoms show up when there is twenty grams or more of this metal in the body.

Diagnosis of argyria

• Causes of blue skin discoloration can be due to different diseases and a differential diagnosis may be necessary to pinpoint this disease.
• If the blue or blue grey skin darken when exposed to sunlight it could be diagnosed as a case of argyria.
• Biopsy of the skin also reveals the presence of silver deposits as blue-brown-black granules, singly or in clusters in the basement membrane zone surrounding the sweat glands, sebaceous glands and surrounding connective tissues.
• Silver is generally detected in the granular material in X-ray microanalysis assay.

Argyria treatment and prevention

• The treatment of this disease starts with immediate stoppage of exposure and seeking medical help.
• The doctor may prescribe topical hydroquinone ointment to reduce the blue skin patches in the case of localized argyria.
• Laser treatment has been successfully carried out in some cases to reduce the intensity of argyria blue patches.
• In some people exposure to high levels of silver particles in air can cause breathing problems, throat irritation and lung  irritation. A qualified doctor must be approached for treatment.
• Similarly contact skin allergies may occur in some people on exposure to this metal and a dermatologist must be consulted for treatment.
• For this generalized blue disorder there is no successful treatment.
• Avoiding sun exposure and using sunscreen helps in preventing this skin discoloration getting worse.
• Chelation therapy and dermabrasion have been tried and found ineffective as treatment for argyria and in removing metal deposits from the body.
• For those working in factories manufacturing various products of silver, wearing protective gear may help in preventing this blue discoloration.
• Environmental Protection Agency (EPA) recommends that the concentration of silver in drinking water not exceed 0.10 milligrams per liter of water (0.10 mg/L) because of the skin discoloration that may occur.

Although silver blue skin pigment changes are permanent, argyria disease usually has no adverse effect on health. Topic of interest:
Stress and skin problems like rashes