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Silver compounds may be absorbed through inhalation, but there are no quantitative human data on the extent of this phenomenon. Silver salts may be absorbed by up to 10%-20% after ingestion. After ingestion in humans, the highest concentrations of silver are usually found in the liver and spleen, but also to some extent in the muscles, skin, and brain. Silver may also be absorbed through dermal exposure, especially via wound care. The biological half-time for silver ranges from a few days for animals up to approximately 50. days for the human liver; it is possible that skin deposits have an even longer half-time, but there are no quantitative data on this for humans. Silver binds to high molecular weight proteins and metallothionein in tissue cytosol fractions. Excretion of silver from the body is primarily biliary. Silver nanoparticles have been shown to be absorbed by both inhalation and oral routes, and only to a minor extent via the dermal route, resulting in deposition in various organ systems. Monitoring of exposure is possible by determinations of levels in whole blood. High-dose repeated exposure of animals to silver and silver compounds may produce anemia, cardiac enlargement, growth retardation, and degenerative changes in the liver. Water-soluble silver compounds such as silver nitrate have a local corrosive effect and may cause fatal poisoning in humans if injected or infused into the uterus. Chronic exposure of humans leads to argyria, a clinical entity characterized by gray-blue pigmentation of the skin and other body viscera. Similar changes in the eye after local treatment with eye drops containing silver compounds are named argyrosis. Allergic contact dermatitis to silver is rare. Genotoxic effects, in terms of direct DNA strand breaks via oxidative stress, have been reported in vitro. Tests indicating genotoxicity (Comet assay) and oxidative stress were positive in one study on silver-workers.

BackgroundLocalized cutaneous argyria is a rare skin condition caused by direct contact with silver or silver particles. It presents as asymptomatic gray or blue-gray macules that appear similar to blue nevi. Histologic features include brown-colored or black-colored silver granules in the basement membrane and dermis, most commonly surrounding eccrine glands, elastic fibers, and collagen fibrils. The condition is most frequently observed in individuals who are regularly exposed to small silver particles, such as silversmiths and welders. However, localized cutaneous argyria has also been associated with acupuncture needles, silver earrings, and topical medications containing silver nitrate. Although the condition is benign, patients who are concerned about the cosmetic features of localized cutaneous argyria may benefit from laser therapy.PurposeWe describe the clinical and pathologic findings of two women who developed localized cutaneous argyria. We also review the characteristics of other patients with localized cutaneous argyria and summarize the differential diagnosis and treatment options for this condition.Materials and methodsThe features of two women with localized cutaneous argyria are presented. Using PubMed, the following terms were searched and relevant citations assessed: acquired localized argyria, acupuncture, argyria, argyrosis, colloidal silver, cutaneous argyria, and localized cutaneous argyria. In addition, the literature on localized cutaneous argyria is reviewed.ResultsTwo women presented with small, asymptomatic blue-gray macules appearing at sites directly adjacent to ear piercings. A punch biopsy was performed on one woman. Microscopic examination revealed a yellowish-brown colored granular material found adjacent to elastic fibers. Based on correlation of the clinical presentation and histopathologic findings, a diagnosis of localized cutaneous argyria was established. The second woman did not undergo a biopsy. However, the clinical presen

BackgroundLocalized cutaneous argyria is a rare skin condition caused by direct contact with silver or silver particles. It presents as asymptomatic gray or blue-gray macules that appear similar to blue nevi. Histologic features include brown-colored or black-colored silver granules in the basement membrane and dermis, most commonly surrounding eccrine glands, elastic fibers, and collagen fibrils. The condition is most frequently observed in individuals who are regularly exposed to small silver particles, such as silversmiths and welders. However, localized cutaneous argyria has also been associated with acupuncture needles, silver earrings, and topical medications containing silver nitrate. Although the condition is benign, patients who are concerned about the cosmetic features of localized cutaneous argyria may benefit from laser therapy.PurposeWe describe the clinical and pathologic findings of two women who developed localized cutaneous argyria. We also review the characteristics of other patients with localized cutaneous argyria and summarize the differential diagnosis and treatment options for this condition.Materials and methodsThe features of two women with localized cutaneous argyria are presented. Using PubMed, the following terms were searched and relevant citations assessed: acquired localized argyria, acupuncture, argyria, argyrosis, colloidal silver, cutaneous argyria, and localized cutaneous argyria. In addition, the literature on localized cutaneous argyria is reviewed.ResultsTwo women presented with small, asymptomatic blue-gray macules appearing at sites directly adjacent to ear piercings. A punch biopsy was performed on one woman. Microscopic examination revealed a yellowish-brown colored granular material found adjacent to elastic fibers. Based on correlation of the clinical presentation and histopathologic findings, a diagnosis of localized cutaneous argyria was established. The second woman did not undergo a biopsy. However, the clinical presen

Silver compounds may be absorbed through inhalation, but there are no quantitative human data on the extent of this phenomenon. Silver salts may be absorbed by up to 10-20% after ingestion. After ingestion in humans, the highest concentrations of silver are usually found in the liver and spleen, but also to some extent in the muscles, skin, and brain. The biological half-time for silver ranges from a few days for animals up to approximately 50 days for the human liver; it is possible that skin deposits have an even longer half-time, but there are no quantitative data on this for humans. Silver binds to high molecular weight proteins and metallothionein in tissue cytosol fractions. Excretion of silver from the body is primarily biliary. Silver nanoparticles have been shown to be absorbed by both inhalation and oral routes, resulting in deposition in various organ systems. Water-soluble silver compounds such as the nitrate have a local corrosive effect and may cause fatal poisoning if swallowed accidentally. Chronic exposure of humans leads to argyria, a clinical entity characterized by gray-blue pigmentation of the skin and other body viscera. Repeated exposure of animals to silver may produce anemia, cardiac enlargement, growth retardation, and degenerative changes in the liver.

Background and objectiveGeneralized 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 methodsAn 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.ResultsImmediate 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.ConclusionQS 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

Background and objectiveGeneralized 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 methodsAn 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.ResultsImmediate 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.ConclusionQS 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

type:text, A case of generalized argyria secondary to "Jintan Silver Pills® " is described. Jintan Silver Pills® are made of natural extracts and coated with silver, and they are very popular as one of the breath fresheners in Japan. The patient has extreme blue-gray pigmentation of her skin. Histopathologically, the fine black granules were present in greatest number in the basement membrane zone surrounding the sweat glands and scattered diffusely through the dermis. She has taken about five hundred Jintan Silver Pills® a day for nineteen years. Her total intake of silver was calculated to be about 350g, which can be sufficient for producing argyria.

A case of generalized argyria secondary to "Jintan Silver Pills® " is described. Jintan Silver Pills® are made of natural extracts and coated with silver, and they are very popular as one of the breath fresheners in Japan. The patient has extreme blue-gray pigmentation of her skin. Histopathologically, the fine black granules were present in greatest number in the basement membrane zone surrounding the sweat glands and scattered diffusely through the dermis. She has taken about five hundred Jintan Silver Pills® a day for nineteen years. Her total intake of silver was calculated to be about 350g, which can be sufficient for producing argyria.

A case of generalized argyria secondary to "Jintan Silver Pills® " is described. Jintan Silver Pills® are made of natural extracts and coated with silver, and they are very popular as one of the breath fresheners in Japan. The patient has extreme blue-gray pigmentation of her skin. Histopathologically, the fine black granules were present in greatest number in the basement membrane zone surrounding the sweat glands and scattered diffusely through the dermis. She has taken about five hundred Jintan Silver Pills® a day for nineteen years. Her total intake of silver was calculated to be about 350g, which can be sufficient for producing argyria.

A case of generalized argyria secondary to "Jintan Silver Pills® " is described. Jintan Silver Pills® are made of natural extracts and coated with silver, and they are very popular as one of the breath fresheners in Japan. The patient has extreme blue-gray pigmentation of her skin. Histopathologically, the fine black granules were present in greatest number in the basement membrane zone surrounding the sweat glands and scattered diffusely through the dermis. She has taken about five hundred Jintan Silver Pills® a day for nineteen years. Her total intake of silver was calculated to be about 350g, which can be sufficient for producing argyria.