A Re-emerging Disease Linked to Complementary Medicine: Argyria

Abstract

Argyria can be described as the deposition of silver in the skin taken orally or through direct skin inoculation, causing discoloration of the skin and mucosa. In recent years, the increasing trend of people towards complementary medicine and marketing the colloidal form of silver is causing a resurgence of cases of argyria. Therefore, we aim to report a 16-year-old male patient who applied to our outpatient clinic and highlight this increasing trend by presenting a patient case. In the presented case, discoloration of the skin is much more pronounced on sun-exposed areas as in the literature, with the catalytic effect of sunlight on silver. In order to avoid this permanent situation, the authorities should take measures such as restricting the sale of products containing silver or limiting the silver content of products. Raising awareness is strongly recommended.

Please cite this article as ”Kayaalti A, Aksu Cerman A, Kivanc Altunay I, Ozkesici Kurt B. A Re-emerging Disease Linked to Complementary Medicine: Argyria. Med Bull Sisli Etfal Hosp 2025;59(2):248-250”.

Argyria is defined as the deposition of silver in the skin, either orally ingested or directly inoculated, causing skin and mucosal discoloration. The term argyria is derived from the Ancient Greek word ‘Argyros.’ Two types of deposition can occur depending on exposure: localized and generalized. It can be primarily seen in some occupational groups, such as jewelers, silver miners, and photographers, due to secondary exposure.^[1] Silver was used in various treatments due to its antimicrobial features before the discovery of antibiotics in the 18^th and 19^th centuries. However, its use is limited due to its toxic effects on the human body nowadays. Ocular gonorrhea and skin burn treatment could be just two of these limited uses of silver.^[2] In recent years, the increasing trend of people towards complementary medicine and marketing the colloidal form of silver is causing a resurgence of cases of argyria.^[3-6] Therefore, we aim to highlight this problem through a patient who applied to our outpatient clinic.

Case Report

A 16-year-old male patient was admitted to our dermatology clinic with a complaint of skin discoloration. In his personal history, he had a congenital urinary tract anomaly. Therefore, he had frequent urinary tract infections and had been treated with multiple antibiotics. The causative agent of his last illness was a multi-drug-resistant bacterium, and there was no response to treatment. To overcome the infection, he took colloidal silver for over a year. The patient's disease improved, but a gray discoloration appeared on his skin (Fig. 1). His dermatological examination was consistent with his complaint, and he had bronze pigmentation on his face, especially on his forehead. The patient's complete blood count, liver and kidney function tests, and eye examination were performed to determine whether there was any other silver accumulation in the internal organs and eyes. There were no abnormal test results, and the eye examination was normal. Due to the psychological burden of the disease on the patient, we recommended Nd:YAG laser treatment.

Figure 1.

Bronze-colored pigmentation on the face, especially in the forehead area.

Discussion

Argyria is a re-emerging disease nowadays, though it is known as an ancient disease. Three hundred sixty-five argyria cases between 1802-1951 were mentioned in a report presented to FDA in 1973.^[7] With the discovery of antibiotics, the use of silver in the treatment was almost abandoned. But, in the past few decades, several cases have been reported in the literature due to colloidal silver.^[8-11] As we presented here, with the growing interest in alternative medicine, argyria has been a matter of concern again in recent years.^[3-6] In addition, wide-open drug marketing, uncontrolled online sales, and misinformation with the increasing rate of internet use are also debatable in this respect. The patient presented here contributes to the gradually increasing incidence of cutaneous argyria as a dramatic result of an unscientific approach. In this regard, a detailed drug history, including herbal and alternative remedies, should be obtained.^[12,13] In the presented case, discoloration of the skin is much more pronounced on sun-exposed areas as reported in the literature, with the catalytic effect of sunlight on silver. And it is known that silver accumulates not only in the skin but also in the eyes, kidneys, liver, intestines, lungs, and blood cells. This accumulation is often a benign condition. However, there have been a few cases of silver toxicity causing night vision loss, neurological impairment, and kidney impairment. Differential diagnosis of argyria includes cyanosis, Addison’s disease, hemochromatosis, Wilson’s disease, ochronosis, methemoglobinemia, and drug-induced hyperpigmentation.^[4,14] Argyria is an irreversible and permanent deposition. In order to avoid this permanent situation, the authorities should take measures such as restricting the sale of products containing silver or limiting the silver content of products. Expanding awareness is highly recommended as a must. There is currently no effective therapy for argyria. On the other hand, it is suggested to use sunscreen to prevent further discoloration.^[10] Recently, a review has indicated that 1064 nm Nd:Yag and alexandrite lasers are a good treatment option for argyria.^[15]

Disclosures

Informed Consent

The consent of patient was given by himself and his mother.

Conflict of Interest

The authors declared that they have no conflict of interests to declare

Financial Support (Funder's Name)

The authors declared that there is no financial relationship relevant to this article

Use of AI for Writing Assistance

The authors declared that no artificial intelligence (AI) - assisted technologies were used in the production of this submitted work.

Authorship Contributions

Concept – A.K., A.A.C., I.K.A., Bi.Oz.K.; Design – A.K., A.A.C., I.K.A., Bi.Oz.K.; Supervision – A.K., A.A.C., I.K.A., Bi.Oz.K.; Fundings – A.A.C., Bi.Oz.K., I.K.A.; Materials – A.A.C., Bi.Oz.K., I.K.A.; Data collection &/ or processing – A.K., A.A.C.; Analysis and/or interpretation – I.K.A., A.A.C., Bi.Oz.K.; Literature search – A.K., Bi.Oz.K.; Writing – A.K., Bi.Oz.K., A.A.C.; Critical review –Bi.Oz.K., A.A.C., I.K.A.