Further distinction can be made with ultrastructural study, based on not only the distribution but also the relative size of the granules (gold is larger than silver silver is larger than mercury) and their aggregation properties. The orange-red birefringence of gold particles with cross-polarized light may be a unique feature. Mercury granules are also found most commonly in macrophages or occasionally in the epidermal basilar layer. Silver particles are largely extracellular and tend to be deposited on basement membranes, around vessels, and on elastic fibers. However, gold granules are larger and more irregular than those of silver and are found predominantly within macrophages. All are refractile on dark-field microscopy. With light microscopy, it may be difficult to distinguish among gold, silver, and mercury deposits. The characteristics of the granules in these conditions distinguish the pigmentation they produce from that due purely to melanin or to pigment-producing drugs such as minocycline, phenothiazines, or antimalarials, which may variably include melanin, a melanin-like drug metabolite, or iron.
#Colloidal silver blue skin
Patterson MD, FACP, FAAD, in Weedon's Skin Pathology, 2021 Differential diagnosis of argyria, chrysiasis, and hydrargyriasis Localized skin biopsy, typically to differentiate argyria from malignant lesions, will show characteristic black-brown globules that are adherent to the dermal elastic fibers, blood vessels, basement membranes, hair follicles, and sweat glands on light microscopy refractile particles on darkfield microscopy and the presence of silver on scanning electron microscopy with energy dispersive radiography.Ĭhelation therapy is not effective for argyria, but successful laser treatment has been reported. The diagnosis of argyria is primarily based on history and physical examination. Rarely, argyria has been reported after the implantation of silver-containing medical devices. Argyria may be localized to the site of exposure, such as with corneal argyria, which was seen in the past from the use of colloidal silver-containing eye drops, or at the site of silver earrings and rings. Argyria can result from inhalation, ingestion, mucosal absorption, or dermal application or exposure. 8 The primary chronic toxicity of silver is argyria, which is a permanent blue-gray discoloration of the skin due to silver deposition over time ( Fig.
When it is ingested continually, silver will be deposited in the skin and the liver.
The ingestion of colloidal silver preparations as a “natural” supplement accounts for the majority of recent cases of significant toxicity. Silver is a broad-spectrum antimicrobial and commonly used as a topical antimicrobial in bandages, catheters, and medical devices. Silver (Ag) is a precious metal long used in coinage and for its antibacterial properties. Lee Goldman MD, in Goldman-Cecil Medicine, 2020 Silver (Argyria)
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