Argyria

Argyria or argyrosis is a condition caused by excessive exposure to chemical compounds of the element silver, or to silver dust.[1] The most dramatic symptom of argyria is that the skin turns blue or blue-grey. It may take the form of generalized argyria or local argyria. Generalized argyria affects large areas over much of the visible surface of the body. Local argyria shows in limited regions of the body, such as patches of skin, parts of the mucous membrane or the conjunctiva.

For other uses, see Argyria (disambiguation).
Not to be confused with agyria.
Argyria
Other namesArgyrosis
Generalized argyria in a 92-year-old male.
SpecialtyDermatology

The terms argyria and argyrosis have long been used interchangeably,[2] with argyria being used more frequently. Argyrosis has been used particularly in referring to argyria of the conjunctiva, but the usage has never been consistent and cannot be relied on except where it has been explicitly specified.[3] The term is from Ancient Greek: ἄργυρος argyros silver.

Pathophysiology

In humans and other animals chronic intake of silver products commonly leads to gradual accumulation of silver compounds in various parts of the body.[4] As in photography (where silver is useful because of its sensitivity to light), exposure of pale or colourless silver compounds to sunlight decomposes them to silver metal or silver sulfides. Commonly these products deposit as microscopic particles in the skin, in effect a dark pigment. This condition is known as argyria or argyrosis.

Chronic intake also may lead to silver pigments depositing in other organs exposed to light, particularly the eyes.[5] In the conjunctiva this is not generally harmful, but it also may affect the lens, leading to serious effects.

Localised argyria often results from topical use of substances containing silver, such as some kinds of eye drops. Generalized argyria results from chronically swallowing or inhaling silver compounds, either for home medicinal purposes, or as a result of working with silver or silver compounds.[6]

While silver is potentially toxic to humans at high doses, the risk of serious harm from low doses, given over a short term, is small. Silver is used in some medical appliances because of its anti-microbial nature, which stems from the oligodynamic effect. Chronic ingestion or inhalation of silver preparations (especially colloidal silver) can lead to argyria in the skin and other organs. This is not life-threatening, but is considered by most to be cosmetically undesirable.[4][5][7][8]

The reference dose, published by the United States Environmental Protection Agency in 1991, which represents the estimated daily exposure that is unlikely to incur an appreciable risk of deleterious effects during a lifetime, is 5 µg/(kg·d).[4]

Argyria worsens and builds up as exposure to silver continues, and does not resolve once exposure stops.

History

Since at least the mid-19th century, doctors have known that silver or silver compounds can cause some areas of the skin and other body tissues to turn grey or blue-grey.[9][10] Argyria occurs in people who ingest or inhale silver in large quantities over a long period (several months to many years). People who work in factories that manufacture silver products can also breathe in silver or its compounds. In the past, some of these workers have become argyric. However, the level of silver in the air and the length of exposure that caused argyria in these workers is not known. Historically, colloidal silver, a liquid suspension of microscopic silver particles, was also used as an internal medication to treat a variety of diseases. In the 1940s, they were overtaken by the use of pharmaceutical antibiotics, such as penicillin.

Society and culture
Colloidal silver is illegally marketed as a medicine, but it is not effective and may interfere with the functioning of some medications, such as antibiotics and thyroxine.[11]

A prominent case from ingestion of colloidal silver was that of Stan Jones of Montana, a Libertarian candidate for the United States Senate in 2002 and 2006. The peculiar coloration of his skin was featured prominently in media coverage of his unsuccessful campaign, though Jones contended that the best-known photo was "doctored".[12] Jones promised that he was not using his silvery complexion as a gimmick. He promoted the use of colloidal silver as a home remedy.[12] He said that his good health, excepting the unusual skin tone, is the result of his use of colloidal silver.[12]

In 2007, press reports described Paul Karason, an American man whose entire skin gradually turned blue after he took a homemade silver chloride colloid and used a silver salve on his face in an attempt to treat problems with his sinus, dermatitis, acid reflux and other issues.[13][14] At the time of the reports, Karason maintained his belief in silver's effectiveness and continued to take it, albeit in smaller doses. He died in 2013 of unrelated causes.[15]

Rosemary Jacobs is a prominent activist against alternative medicine. As a child, Jacobs was treated for allergies with nose drops that contained colloidal silver, and developed argyria as a result.[16] Jacobs came to international attention after Paul Karason was on The Today Show in 2008.[17][18] From 2010 to 2013, Jacobs posted about topics in health fraud, particularly naturopathy, on her blog.[19]

Possible implications

Although research is still not definitive, the literature has suggested that argyria can cause a decrement in kidney function. Additionally, a lack of night vision may be present.[20] The lack of night vision would most likely be due to damaged rods in the eye, from the exposure to silver or silver dust particles in the ocular region.

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See also

References
  1. James, William D.; Berger, Timothy G.; Elston, Dirk M.; Odom, Richard B. (2006). Andrews' diseases of the skin: clinical dermatology. Saunders Elsevier. p. 858. ISBN 0-7216-2921-0. OCLC 62736861.
  2. Guttmann, Paul. tr. by A. Napier. A handbook of physical diagnosis comprising the throat, thorax and abdomen. 1879. May be downloaded from https://archive.org/details/ahandbookphysic02guttgoog
  3. Fox, Lawrance Webster. A practical treatise on ophthalmology. Pub. D. Appleton and company NY. 1920. May be downloaded from https://archive.org/details/apracticaltreat00foxgoog
  4. Fung MC, Bowen DL (1996). "Silver products for medical indications: risk-benefit assessment". Journal of Toxicology. Clinical Toxicology. 34 (1): 119–26. doi:10.3109/15563659609020246. PMID 8632503.
  5. Lansdown AB (2006). "Silver in health care: antimicrobial effects and safety in use". Biofunctional Textiles and the Skin. Current Problems in Dermatology. 33. pp. 17–34. doi:10.1159/000093928. ISBN 3-8055-8121-1. PMID 16766878.
  6. Brandt D, Park B, Hoang M, Jacobe HT (August 2005). "Argyria secondary to ingestion of homemade silver solution". Journal of the American Academy of Dermatology. 53 (2 Suppl 1): S105–7. doi:10.1016/j.jaad.2004.09.026. PMID 16021155.
  7. "ToxFAQsTM for Silver". July 1999. Archived from the original on 2001-07-20.
  8. "Public Health Statement: Silver" (PDF). ATSDR.
  9. London Medical Gazette: Or, Journal of Practical Medicine. 1843. pp. 791–. Retrieved 13 July 2013.
  10. The Cincinnati Lancet and Observer. E.B. Stevens. 1859. pp. 141–. Retrieved 13 July 2013.
  11. "Colloidal Silver". NCCIH.
  12. Stan Jones letter
  13. Feeling Blue Over Skin Color | ABC News
  14. "Why This Man Turned Blue". Today. NBCNEWS.com. 7 January 2008. Retrieved 19 November 2015.
  15. "Internet Sensation 'Papa Smurf' Dies, Other Blue People Live On". ABC News. 25 September 2013. Retrieved 26 October 2017.
  16. Jacobs, Rosemary (1998). "My Story". Rosemary's Story. Retrieved 19 November 2015.
  17. "Woman who turned silver warns of dangers of internet medicines". The Telegraph. 5 September 2008. Retrieved 19 November 2015.
  18. Hit Blames on Colloidal Silver (5 September 2008). "Colloidal Silver: FAQ". WebMD. Retrieved 19 November 2015.
  19. Jacobs, Rosemary. "Rosemary's Medical Blog". Retrieved 19 November 2015.
  20. Rosenman KD, Moss A, Kon S (June 1979). "Argyria: clinical implications of exposure to silver nitrate and silver oxide". Journal of Occupational and Environmental Medicine. 21 (6): 430–435. PMID 469606.
Classification
External resources
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