Argyrosis
Last reviewed: 18.10.2021
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With the accumulation of silver in the tissues of the body (in ancient Greek - argyros, in Latin - argentum), a disease such as argyrosis or argyria can occur.
In the section on toxic effects of metals in ICD-10, this condition has the code T56.8 (with a dermatological specification).
Epidemiology
Argyrosis is rare and there are no precise statistics on reported cases. But, since the development of this condition requires long-term exposure to silver nanoparticles on the body, it usually occurs in fairly mature and elderly people. [1]
Causes argyrose
The main reasons are the abnormal effects of chemical compounds of silver or its fine particles (silver dust) on the skin and mucous membranes - with prolonged contact with them - or ingestion as a result of industrial exposure or iatrogenic action of pharmacological agents containing silver salts.
These include silver nitrate, colloidal silver - a liquid suspension of microscopic silver particles (these are the intranasal preparations Collargol and Protargol used in otolaryngology), silver-containing eye drops, as well as external agents (containing silver salts) with antiseptic and antimicrobial action - for the treatment of purulent wounds, burns, trophic ulcers, pyoderma, etc.
The deposition of silver stains the skin and mucous membranes gray or blue-gray. [2]
Risk factors
Risk factors for the development of argyrosis have been identified, such as prolonged contact of people with silver and its compounds during the extraction and purification of silver, the production of silver items and alloys, metal films on glass, etc.
The impetus for the accumulation of this metal can be the prolonged use of the above drugs, the constant use of cosmetics with silver ions or the intake of various additives (dietary supplements) with colloidal silver. By the way, as the FDA officially declares, such supplements are unsafe and ineffective.
Pathogenesis
Studying the pathogenesis of argyrosis (argyria), experts came to the conclusion that, due to professional activity, with prolonged contact with the skin, silver nanoparticles are able to impregnate it directly (mechanically).
After the ingestion of soluble forms of silver in the small intestine, almost 10% of the supplied silver is absorbed, from the intestine it is transferred into the blood and, by binding to the plasma protein, penetrates into the tissues. And most of all it is deposited in the skin (in the basement membrane of the epithelium), the cornea and mucous membranes. [3]
Under the influence of UV radiation, a compound of silver and a protein undergoes photoreduction with the formation of metallic silver, which is oxidized by tissue enzymes to practically insoluble inorganic compounds - selenide and silver sulfide, which have the appearance of dark gray and brown-black granules (less than 1 μm in size).
In addition to argyrosis, exposure to soluble silver compounds can cause liver and kidney damage, irritation of the eyes, skin, respiratory tract and intestines, and blood changes.
Symptoms argyrose
The most common symptom of argyrosis is blue, bluish gray, or ash gray skin color. Moreover, the degree of such pigmentation is directly related to the amount of silver present.
There are different types of argyrosis: generalized (with damage to large areas of the skin exposed to sunlight, including the face, ears, hands, nails, eyes) [4]and local - on limited areas of the skin, mucous membrane, on the conjunctiva of the eyes or Descemet membrane of the cornea ( causing the whites of the eyes to turn gray-blue). [5]
The first signs of generalized argyrosis are manifested by gray-brown staining of the gums.
Local argyrosis - in the form of spots ranging from light brown to dark blue - is usually caused by direct external contact with silver compounds, for example, after applying topical agents.
Diagnostics argyrose
Diagnostics is carried out by a dermatologist who conducts a physical examination and finds out what drugs or dietary supplements the patient is taking.
Analysis is limited to skin biopsy of pigmented areas and histopathological examination of the specimen. [8]
Differential diagnosis
Differential diagnosis should take into account methemoglobinemia, hemochromatosis, melanoma, [9]alkaptonuria, exogenous ochronosis (caused by phenol derivatives) and focal pigmented lesions of the conjunctiva.
Who to contact?
Treatment argyrose
The pigmentation caused by silver deposits is irreversible, and there is no effective treatment for argyrosis.
Although, laser therapy or dermabrasion with a laser can help to a limited extent.
Prevention
It is possible to prevent argyrosis by limiting the use of medications containing silver and not taking dietary supplements with colloidal silver.
And the prevention of exposure to silver compounds at work - protective equipment appropriate to safety.
Forecast
For the overall life expectancy, the prognosis of argyrosis is favorable, which cannot be said about its quality, since this condition does not go away even after the cessation of exposure to silver.
So, even as a child, American Rosemary Jacobs was treated with nasal drops with colloidal silver for allergic rhinitis, which caused her to develop argyrosis. And she told about what kind of disease it is in her book "Argyria: the life and adventures of a silver woman on planet Earth."