1/12. Generalized argyria in two chronic hemodialysis patients.silver can be absorbed through ingestion, topical administration, or inhalation. Generalized argyria results from deposition of silver in the skin, nails, mucous membranes, and internal organs and is characterized by a diffuse bluish-gray discoloration in sun-exposed areas. We report two cases of generalized argyria in patients on maintenance hemodialysis (HD) therapy for more than 15 years. They presented with diffuse hyperpigmentation of the face that was mistaken to be related to uremia and bluish-gray discoloration of all nails believed to be cyanosis. Histopathologic examination of skin biopsy specimens showed characteristic findings of argyria, which was further confirmed by radiograph microanalysis. Their serum silver levels were also elevated. No definite silver source could be determined. However, their argyria might be related to their long-term HD therapy because (1) they had been on HD therapy for more than 15 years and the discoloration appeared several years afterward, and (2) the water used for HD was not well processed in the early 1980s in taiwan: argyria should be suspected in chronic HD patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/12. Multifocal corneal argyrosis after an explosion injury.PURPOSE: To document the clinical and histopathologic corneal features of a patient who developed multifocal corneal argyrosis after a chemical explosion injury with unusual involvement of the corneal stroma and keratocytes. methods: The corneal button was investigated by light and transmission electron microscopy and scanning electron microscopy combined with energy-dispersive x-ray microanalysis. RESULTS: Clinically, the patient showed dark discoloration of the lids, periocular skin, episclera, and conjunctiva and had multiple brown dots in the superficial layers of the cornea. Microscopic examination of the cornea showed diffuse deposition of silver particles in the epithelial basement membrane, Bowman's layer, and Descemet's membrane. In the corneal stroma, silver granules accumulated intracellularly within lysosomal structures of degenerative keratocytes and extracellularly in association with collagen fibers and cellular debris. Energy-dispersive x-ray analysis showed peaks of silver and sulfur. CONCLUSION: The toxic influence of intracellular accumulation of silver in stromal keratocytes may lead to cell damage and necrosis and result in visual impairment.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
3/12. argyria associated with colloidal silver supplementation.A 65-year-old male presented for skin examination and was incidentally noted to have discoloration of the fingernails. These findings were completely asymptomatic. The patient had been taking colloidal silver supplementation (Silverzone 140 ppm silver Gifts of nature, St. George, UT, USA) for 2 years as therapy for diabetes. He first noticed the onset of nail discoloration 1 year ago. His past medical history included type II diabetes and hypertension. His current medications were metformin, glyburide, and benazepril. physical examination revealed slate-gray discoloration involving the lunulae of the fingernails (Fig. 1). The skin, mucous membranes, and sclerae were unaffected.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/12. Corneal argyrosis associated with silver soldering.We report a patient who developed corneal argyrosis secondary to occupational silver soldering. Clinically, the cornea was notable for a green-brown discoloration localized to Descemet's membrane by slit-lamp biomicroscopy. silver particles were identified within the anterior three eighths of Descemet's membrane by light and electron microscopy and energy-dispersive x-ray microanalysis. To our knowledge, the association between corneal argyrosis and silver soldering has not been previously reported.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
5/12. Long-term use of silver containing nose-drops resulting in systemic argyria.Generalized argyria is a silver intoxication that results in pigmentation due to deposition of silver in the skin and mucous membranes. Compared to several decades ago, argyria is now relatively rare. We report a case of generalized argyria after continous use of argyrophedrine nosedrops in the last ten years. argyria should be taken into consideration when a patient presents with a blue-grey discoloration of the skin, particulary in areas exposed to the sun.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
6/12. Ocular argyrosis after long-term self-application of eyelash tint.PURPOSE: To report cases of ocular argyrosis that developed after long-term self-application of commercially available eyelash tint. DESIGN: Observational case series. methods: Case review, clinicopathologic analysis, and literature review. RESULTS: Three patients developed ocular argyrosis after the long-term self-application of Revlon Professional Roux Lash and Brow Tint (Colomer USA Corp, new york, new york, USA). Clinical evaluation revealed various degrees of silver deposition on the upper eyelid, lid margin, caruncle and conjunctiva, and diffuse Descemet's membrane deposits. In one case, histologic examination demonstrated silver deposition in the basement membrane and superficial substantia propria of the conjunctiva. CONCLUSIONS: Argyrosis can occur after long-term application of readily available eyelash tints, and the deposition of silver may be permanent. In certain circumstances, conjunctival argyrosis may simulate benign and malignant lesions, including conjunctival melanoma. These products should only be applied by trained cosmetologists.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
7/12. Generalized argyrosis in man: neurotological, ultrastructural and X-ray microanalytical findings.Generalized argyrosis can produce a number of abnormalities, including skin discoloration, liver and kidney dysfunction. We describe a patient with generalized argyrosis following long-term self-treatment with oral silver intake, in whom skin discoloration, progressive taste and smell disorders, vertigo and hypesthesia were observed. These findings were confirmed by chemosensory tests and electrophysiological investigations. The development of hypogeusia was assessed by subjective tests, while the progression of hyposmia was followed by recording olfactory evoked cortical potentials. light and electron microscopy of tissue samplings demonstrated electron-dense mineral deposits in basal membranes, in macrophages, in the perineurium of peripheral nerves, along elastic and collagenous fibers, and in necrotic cells of the oral submucosa. silver and sulfur deposits in affected tissues could be defined by X-ray microanalysis. The quantitative ratio between silver and sulfur in involved tissues was similar to that of an inorganic silver-sulfide (Ag2S) standard. The minute increase in the sulfur content when compared to the inorganic standard suggested a sulfur containing organic matrix of the tissue precipitates. Our findings indicate that the affinity of silver for membrane and neuronal structures and the deposition of silver as an insoluble compound (Ag2S) induce the progression of clinical disease.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
8/12. Blue macules of localized argyria caused by implanted acupuncture needles. Electron microscopy and roentgenographic microanalysis of deposited metal.acupuncture needles implanted in the skin for more than ten years caused peculiar bluish macules, each of which clinically resembled a blue nevus in the extremities of a 63-year-old Japanese woman. Histologically, the involved skin showed deposition of fine brownish granules in the basement membrane of the eccrine sweat glands, on the inner surface of the blood vessel walls, and along elastic fibers of the superficial dermis in addition to sparse deposits noted throughout the dermis. Electron microscopy revealed deposits of electron-dense particles on the basal lamina of the secretory coils of the eccrine sweat glands, below the basal lamina of the dermoepidermal junction, and on elastic fibers. Roentgenographic microanalysis of the involved skin demonstrated that most of the granules consisted of silver and chloride; silver was a major component in the removed needles.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
9/12. brain involvement in generalized argyria.Cutaneous argyria was diagnosed in a 59-year-old woman. Manic depressive psychosis developed at about the same or a short time thereafter. The patient died 6 years later from a ruptured aortic aneurysm. At autopsy silver deposits were seen in skin, mucous membranes, heart, kidney, and liver. In the central nervous system the leptomeninges and choroid plexuses contained silver granules. In addition, silver granules were visualized in the walls of many intraparenchymal vessels, particularly of the basal ganglia, hypothalamus, substantia nigra, and cerebellum. Progressive glial changes and cellular gliosis were evident in many areas of the brain. With the electron microscope the deposition of silver granules in basal membrane structures of the choroid plexus and intracerebral vasculature was amply confirmed. Furthermore, silver deposition was seen in brain parenchymal cells inside bodies of apparently lysosomal nature. The silver content of various brain regions was determined by absorption spectrophotometry.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
10/12. silver-blue nails.The case is reported of a man with uniformly silver-blue discolouration of all fingernails, with deeper colouring over the lunulae. The nail bed changes resulted from the uncontrolled ingestion of a silver-containing granular powder. The total silver intake was over 15 g. The only other sign of argyrosis was a barely perceptible greyish discolouration over the cheeks and in the sclerae. Biopsies were taken from the nail bed and the cheek. Electron microscopy revealed metallic deposits in elastic fibres and basement membranes. The silver deposition was much heavier in the nail bed than in facial skin. Long-wave ultraviolet light (UVA) and lack of melanin protection seem to be responsible for this phenomenon. Argyrosis and the differential diagnosis of nail discolourations are reviewed.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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