In some cases, the entire skin turns a slate blue-grey colour.The fingernails, conjunctival membranes and mucous membranes may become hyperpigmented.Hence, the discolouration is thought to result from the presence of silver and silver-induced increase in melanin concentration. The hyperpigmentation is most pronounced in sun-exposed areas such as the face (particularly forehead and nose), neck, arms, and hands.Over a period of months or years depending on the degree of exposure the skin turns a bluish-grey, metallic, to slate-grey colour.Generalised argyria usually begins with a grey-brown staining of the gums which later progresses to involve large areas of the skin.
What is apparent is that the degree of hyperpigmentation in patients is directly correlated with the amount of silver present. Whether or not a person exposed to prolonged or high levels of silver develops argyria depends on many factors including the dose and form of exposure, the duration of exposure, and the route of exposure (ie: ingested, inhaled, skin contact). What are the clinical features of argyria? There may be a genetic predisposition for argyria. Circus freak Captain Fred Walters the blue man, ingested silver nitrate to deepen his colour and improve his income, but died from the habit. In several cases patients were manufacturing colloidal silver suspension at home using instructions downloaded from the Internet. Silver toxicity is rare today. However, there have been several reports of people getting argyria after using colloidal silver-based products as ‘cure-alls’. Most absorbed silver is excreted in faeces and some in the urine. Some of this silver is carried as a salt and may be deposited in various tissues, with highest concentrations found in the skin, liver, spleen and adrenals. Silver taken orally or absorbed by mucous membranes is carried through blood bound to the plasma protein albumin. Most occupational argyria is due to the direct impregnation of silver salts from prolonged contact with skin. Silver enters the body either by mechanical impregnation of the skin by small silver particles or by ingestion of silver compounds.
Medication with silver salts – prolonged use of silver salts for the irrigation of urethral or nasal mucous membranes, in eye drops, wound dressing, and excessive use of an oral smoking remedy containing silver acetate.Occupational exposure – mainly in workers involved in silver mining, silver refining, silverware and metal alloy manufacturing, metallic films on glass and china electroplating solutions, and photographic processing.There are several sources of exposure to silver. Argyria is a condition characterised by bluish-grey to slate-grey staining of the skin and mucous membranes caused by deposition of silver particles in the skin.
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