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2.
Head Neck Pathol ; 12(2): 252-254, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28779465

RESUMO

A biopsy specimen from the nasal mucosa of a 37-year-old man disclosed a subepithelial accumulation of black granules mainly running parallel to the surface in the absence of any inflammatory infiltrate. Since the mucosal pigment was negative with Perls' stain and resisted to melanin bleach, an exogenous pigmentation was suspected. The biopsy specimen had been taken because of a diffuse steel-blue pigmentation of the nasal mucosa, incidentally discovered during routine clinical examination. A diagnosis of occupational argyria of the nasal mucosa was finally made since the patient was a silver cleaner. Argyria is a rare cause of nasopharyngeal mucosal pigmentation; it is not a precancerous condition, but it can be mistaken for a melanosis or a melanocytic tumor both clinically and histopathologically. Clinicopathological correlation is mandatory, since the final diagnosis is based on a history of chronic silver exposure.


Assuntos
Argiria/diagnóstico , Argiria/etiologia , Mucosa Nasal/patologia , Exposição Ocupacional/efeitos adversos , Prata/efeitos adversos , Adulto , Humanos , Masculino
3.
Optom Vis Sci ; 94(11): 1066-1069, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28990988

RESUMO

SIGNIFICANCE: This report details the natural history of corneal argyrosis over 3 years using in vivo confocal microscopy to document regression of hyperreflective deposits, as well as effects on corneal nerves and endothelial cell morphology. PURPOSE: To report the in vivo confocal microscopic features and clinical characteristics of a case of bilateral corneal argyrosis. CASE REPORT: A 52-year-old man referred to us 3 months following cautery of the palpebral conjunctiva of both eyes with a silver nitrate stick was observed over the course of 3 years, during which slit-lamp photography and in vivo confocal microscopy were performed. At the first visit, slit-lamp examination showed a light blue-green discoloration and a thick, yellow, oval discoloration in the right and left cornea, respectively. One year later, under slit-lamp examination, the right cornea appeared nearly transparent, and the discoloration in the left cornea had remarkably regressed. In vivo confocal microscopy done at that time showed highly reflective deposits in Descemet membrane of the right cornea and throughout Bowman layer, the stroma, and Descemet membrane of the left cornea. Three years later, no accumulation of silver was observed during slit-lamp examination of either eye. In vivo confocal microscopy of the right cornea did not reveal any silver deposits, and the corneal structure appeared normal. In the left cornea, some silver deposits were still evident in Descemet membrane, and alterations of corneal nerve and endothelial cell morphology were also evident. CONCLUSIONS: This report reviews the 3-year natural history of a patient with corneal argyrosis. In vivo confocal microscopy demonstrates that over time the corneal argyrosis gradually resolves without any treatment. However, the presence of silver in the cornea may impact the corneal nerves and endothelial cells.


Assuntos
Argiria/diagnóstico , Córnea/inervação , Doenças da Córnea/induzido quimicamente , Microscopia Confocal/métodos , Córnea/efeitos dos fármacos , Doenças da Córnea/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade
4.
Cornea ; 36(6): 747-748, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28399037

RESUMO

PURPOSE: To present a novel case of ocular argyrosis mimicking conjunctival melanoma. METHODS: A 48-year-old man who is a jewelry manufacturer presented with raised pigmented lesions in the inferior fornices of both eyes. Brown-black colored, follicle-like, masses were observed in both fornices. RESULTS: An incisional biopsy confirmed the presence of silver and the diagnosis of ocular argyrosis. CONCLUSIONS: Despite its limited negative health effects, ocular argyrosis should be considered in the differential diagnosis of conjunctival pigmented lesions because of the potential for misidentification of neoplastic growth.


Assuntos
Argiria/diagnóstico , Neoplasias da Túnica Conjuntiva/diagnóstico , Doenças Palpebrais/diagnóstico , Melanoma/diagnóstico , Doenças Profissionais/diagnóstico , Argiria/cirurgia , Biópsia , Diagnóstico Diferencial , Doenças Palpebrais/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/cirurgia , Prata
6.
Doc Ophthalmol ; 133(2): 129-138, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27392933

RESUMO

PURPOSE: The aim of this report is to present a case of a patient, metal foundry worker, who had been exposed to industrial silver salts for over 20 years. It is well established that chronic exposure to silver compounds can cause accumulation of silver deposits in various tissues. This condition is referred to as argyrosis or argyria, whereas changes related to eye tissues are defined as ocular argyrosis. METHODS: A complete eye examination, corneal confocal microscopy, kinetic and static visual field test, posterior segment optical coherent tomography, pattern visual evoked potentials (PVEP), flash visual evoked potentials, multifocal electroretinogram, pattern electroretinogram (PERG), full-field electroretinography (FERG) and electrooculogram were all performed. RESULTS: Eye examination revealed decreased visual acuity, corneal deposits and drusenoid changes within the macula. Although electrophysiology tests did not show changes in the function of retinal pigment epithelium, they revealed abnormal function of photoreceptors in the central and peripheral retina. PERG abnormalities and delayed latency of P100 wave in PVEP confirmed impaired function of the inner layers of the retina in the macular region. CONCLUSIONS: Corneal confocal microscopy and electrophysiological tests may help confirm the diagnosis of ocular argyrosis.


Assuntos
Argiria/diagnóstico , Doenças da Córnea/diagnóstico , Metalurgia , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Prata/efeitos adversos , Transtornos da Visão/diagnóstico , Idoso , Humanos , Masculino
7.
BMC Nephrol ; 17(1): 49, 2016 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-27189346

RESUMO

BACKGROUND: Silver is a transition metal, toxic when ingested in significant amounts, causing argyria (skin deposition) and argyrosis (eye deposition). It is excreted mainly via the gastrointestinal tract with only small amounts eliminated by the kidneys, and rarely have cases of nephrotoxicity due to silver been reported. Here we present the case of a woman who used colloidal silver as an alternative remedy for a T cell lymphoma, who subsequently developed argyria and a pauci-immune crescentic glomerulonephritis with evidence of extensive glomerular basement membrane silver deposition. CASE PRESENTATION: A 47 year old woman of Indo-Asian descent with a T-cell lymphoma who refused conventional chemotherapy for 18 months but self-medicated with a remedy containing colloidal silver, was admitted with acute dialysis-dependent kidney injury. A kidney biopsy demonstrated a pauci-immune crescentic glomerulonephritis with deposition of silver particles in the mesangium and along the glomerular basement membranes. The patient was treated with intravenous methylprednisolone and intravenous cyclophosphamide and recovered independent renal function. CONCLUSION: Chronological evolution of the the pauci-immune glomerulonephritis suggests that a cellular immune-mediated process was induced, potentially mediated by lymphomatous T cells directed at the glomerular basement membrane, following silver deposition. Immunosuppressive therapy improved the situation and allowed cessation of haemodialysis, supporting the hypothesis of an immune-mediated process.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/induzido quimicamente , Argiria/tratamento farmacológico , Glomerulonefrite/induzido quimicamente , Linfoma de Células T/tratamento farmacológico , Prata/efeitos adversos , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/diagnóstico , Argiria/complicações , Argiria/diagnóstico , Feminino , Glomerulonefrite/complicações , Glomerulonefrite/diagnóstico , Humanos , Linfoma de Células T/complicações , Linfoma de Células T/diagnóstico , Pessoa de Meia-Idade , Prata/administração & dosagem
9.
Dermatol Online J ; 22(11)2016 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-28329568

RESUMO

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 presentation was highly suggestive of localized cutaneous argyria. Both women were reassured of the benign nature of the condition and agreed to return for clinical follow-up if they observed any changes in the appearance of the lesions.


Assuntos
Argiria/diagnóstico , Otopatias/diagnóstico , Joias/efeitos adversos , Dermatopatias/diagnóstico , Adulto , Idoso , Argiria/etiologia , Argiria/patologia , Diagnóstico Diferencial , Otopatias/etiologia , Otopatias/patologia , Feminino , Humanos , Nevo Azul/diagnóstico , Dermatopatias/etiologia , Dermatopatias/patologia
12.
J Drugs Dermatol ; 14(7): 760-1, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26368981

RESUMO

Argyria is an uncommon blue-gray pigmentation of the skin (increased in sun-exposed areas), nail unit, and mucous membranes caused by prolonged silver exposure. Commonly occurs in the setting of occupational exposure, silver-containing medications, or systemic absorption from use of silver sulfadiazine on extensive burns/wounds. Recently, there appears to be an increase in the practice of colloidal silver ingestion given the popularity and easy availability of alternative medicines and dietary supplements containing various silver-containing compounds. We report a case of argyria in a 72-year-old male following ingestion of colloidal silver as a supplement for over 10 years. He had a diffuse, blue-gray discoloration of his face and nails. A skin biopsy was performed and histology supported the clinical diagnosis of argyria. Our objective is to increase the awareness for this rare dermatologic entity by highlighting the clinical and histological features through a case report. Dermatologists should warn patients in regards to the use of colloidal silver for alternative health practices.


Assuntos
Argiria/diagnóstico , Idoso , Argiria/etiologia , Argiria/patologia , Suplementos Nutricionais/efeitos adversos , Humanos , Masculino , Prata/efeitos adversos , Pele/patologia
15.
J Craniofac Surg ; 25(2): e149-51, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24621755

RESUMO

Localized nasal argyria has been reported in 3 published articles as secondary to occupational exposure and involving the anterior part of the nose. No previous cases of such pathology involving the rhinopharynx were described. Here we report the first case of localized argyria of the roof and of the posterior wall of the rhinopharynx secondary to prolonged use of nasal drops containing colloidal silver protein. The recognition of such pathology can be useful to increase the number of conditions that must be considered in the differential diagnosis of rhinopharyngeal mucosa alterations.


Assuntos
Argiria/diagnóstico , Argiria/etiologia , Hidrogéis/administração & dosagem , Hidrogéis/efeitos adversos , Doenças Nasofaríngeas/induzido quimicamente , Doenças Nasofaríngeas/diagnóstico , Compostos de Prata/administração & dosagem , Compostos de Prata/efeitos adversos , Administração Intranasal/efeitos adversos , Argiria/patologia , Feminino , Humanos , Hipertrofia/patologia , Doença Iatrogênica , Pessoa de Meia-Idade , Nasofaringe/patologia
17.
Dermatol. argent ; 20(5): 335-338, 2014. ilus
Artigo em Espanhol | LILACS | ID: lil-784815

RESUMO

La argiria es la intoxicación por plata, generalmente secundaria a medicamentos o a una enfermedad profesional. Se deposita tanto en piel como en órganos internos, otorgandoa los tegumentos una coloración gris azulada denominada cerulodermia. Esto plantea el principal diagnóstico diferencial con cianosis. Se presenta el caso de una paciente de 50 años de edad, que durante un período de 10 años aplicó sulfadiazina de plata tópica en úlceras de miembros inferiores. La absorción sistémica de este metal determinó la aparición progresiva del cuadro...


Assuntos
Humanos , Argiria/diagnóstico , Sulfadiazina de Prata , Prata
18.
Dermatol. argent ; 20(5): 335-338, 2014. ilus
Artigo em Espanhol | LILACS | ID: lil-784822

RESUMO

La argiria es la intoxicación por plata, generalmente secundaria a medicamentos o a una enfermedad profesional. Se deposita tanto en piel como en órganos internos, otorgandoa los tegumentos una coloración gris azulada denominada cerulodermia. Esto plantea el principal diagnóstico diferencial con cianosis. Se presenta el caso de una paciente de 50 años de edad, que durante un período de 10 años aplicó sulfadiazina de plata tópica en úlceras de miembros inferiores. La absorción sistémica de este metal determinó la aparición progresiva del cuadro...


Assuntos
Humanos , Argiria/diagnóstico , Sulfadiazina de Prata , Prata
19.
Indian J Dermatol Venereol Leprol ; 79(6): 805-11, 2013 Nov-Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24177615

RESUMO

Argyria is an uncommon grey-blue pigmentation of skin and mucous membranes caused by prolonged silver exposure. The impetus behind this review is our experience with cases of generalized argyria resulting from a uniquely Indian socio-cultural practice and belief that it is under reported. Our objective is to increase the awareness for this esoteric entity through a review of the pertinent literature and to highlight clinical and histological features using our four well worked-up cases as examples.


Assuntos
Areca/efeitos adversos , Argiria/diagnóstico , Argiria/etiologia , Argiria/etnologia , Diagnóstico Diferencial , Feminino , Humanos , Índia/etnologia , Masculino , Pessoa de Meia-Idade
20.
Ophthalmic Surg Lasers Imaging Retina ; 44 Online: E20-2, 2013 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-24256711

RESUMO

A 68-year-old Caucasian man with a remote history of daily colloidal silver ingestion presented for ophthalmic examination in which he was noted to have a distinct slate gray skin discoloration. Funduscopy revealed confluent perimacular drusenoid deposits bilaterally, most of which localized at the level of or anterior to the inner segment ellipsoid band by optical coherence tomography (OCT) imaging. Enhanced depth imaging OCT demonstrated marked choroidal thinning. Fluorescein angiogram displayed a dark or silent choroid. Confirmatory serum silver levels were found to be markedly elevated. This report describes a unique geographic maculopathy with large drusenoid deposits anterior to the ellipsoid layer and severe choroidal thinning in association with ocular argyrosis.


Assuntos
Argiria/diagnóstico , Doenças da Coroide/diagnóstico , Drusas Retinianas/diagnóstico , Tomografia de Coerência Óptica , Idoso , Argiria/sangue , Doenças da Coroide/sangue , Angiofluoresceinografia , Humanos , Masculino , Drusas Retinianas/sangue , Escotoma/sangue , Escotoma/diagnóstico , Compostos de Prata/sangue , Compostos de Prata/toxicidade
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