Argyrie is a discoloration of the skin and mucous membranes that appears gray-bluish or slate gray and is irreversible. Argyriasis is caused by ingestion of silver in the form of metallic silver, silver-containing medications, colloidal silver, silver salts, or silver dust. The disease argyriasis belongs to the dyschromias.
What is argyriasis?
The discoloration of the surface of the skin that occurs in argyriasis occurs in the generalized form. It particularly affects skin exposed to sunlight. The discoloration occurs due to light-influenced deposition of silver-containing granules, in which silver sulfide has been detected several times. These silver deposits are located on areas of the skin that receive a lot of sunlight. In argyrics, i.e., persons suffering from argyriasis, granules containing silver are detected especially near the sweat glands and basement membrane. Silver may be deposited in other organs. Another symptom is a higher melanin synthesis, which additionally affects the discoloration of the skin. Only the epidermis, the uppermost layer of the skin, is unaffected by silver deposition. High amounts of silver are necessary to trigger generalized arygyria. Even a cumulative intake of more than one gram can lead to argyriasis.
Causes
The causes of argyriasis are contact with silver salts over prolonged periods of time or ingestion of silver salts. In the beginning, discoloration appears only on the gums, and only later does the entire skin become discolored due to silver deposition. Areas exposed to sunlight are most affected. The degree of expression depends on the duration of exposure and the dose of silver absorbed until pigment changes appear. One of the main reasons why argyrosis occurs less frequently today is due to the fact that drugs containing silver are no longer available on the market, and occupational exposure to argyrosis is less common today. Occupational exposure can result in contact with silver when absorbed through silver dusts in the metal industry or silver salts in the photo laboratory. Other possible sources of danger are silver sutures performed in abdominal surgery or a puncture with an acupuncture needle. Other possible sources of argyriosis include the medical application of wound tinctures and eye drops or silver-containing dietary supplements against AIDS, diabetes mellitus, herpes infections and cancer. The human body normally has one milligram of silver. The use of silver-containing nasal drops, silver-containing smoking cessation tablets, and silver dusts or colloidal silver are also triggers for the development of argyriasis.
Symptoms, complaints, and signs
The first discoloration that sets in with argyriasis is a condition called lunulae from the fingernails. After that, a grayish-bluish discoloration continues on other areas of the body. In particular, areas of the skin that can be reached by sunlight show the typical discoloration processes associated with the diagnosis of argyriasis. The first symptoms of argyriasis are manifested in complaints such as kidney failure or the appearance of night blindness. Deposits of silver detected in the eye are called argyrosis. These signs are particularly common at the beginning and in the middle of the last century, partly due to the inevitable association with corresponding occupations and the handling of silver appropriate to the time. Other signs of a possible clinical picture of argyriasis may include neurological symptoms, psychomotor retardation, the occurrence of seizures and spasticity, and swallowing symptoms and reduced muscle tone.
Diagnosis and course
The diagnosis of argyriasis is confirmed by a biopsy of the skin, because in the histologic area, round granules of brown-black coloration are found, especially around the basement membrane from the sweat glands, in small groupings or occurring singly. In order to be able to investigate the occurrence more precisely, the occupational background, i.e. the occupational exposure of those affected, but also influences by the environment or additives to diets are closely scrutinized. Signs of argyrie appear on the body already at a silver content of four to five grams. 50 to 500 milligrams per kilogram is already a lethal dose for the human body.Therefore, it is important for affected individuals and the preservation of their health to confirm the diagnosis quickly in order to respond appropriately. Argyriasis occurs generalized or locally. However, it is irreversible. Local discoloration can occur when wearing silver earrings, but also when silver acupuncture needles are left in human tissues for a long period of time. Care should be taken even when using silver surgical suture materials.
Complications
Argyriasis is an irreversible disease. In most cases, the patient’s skin turns gray, blue, or almost black. In most cases, only the nails are discolored at first. Only then does the symptom spread to the surrounding areas of the body. Direct exposure to sunlight intensifies the effect of argyriasis. For this reason, affected individuals should avoid direct exposure to the sun. It is not uncommon to experience problems with the kidneys and so-called night blindness. In rare cases, argyriasis also affects the psyche. Here, limitations in thinking and acting can occur. Cramps occur more frequently and the patient complains of pain in the muscles and joints. The quality of life is greatly reduced by argyrias, and the patient can no longer perform ordinary activities without difficulty. There is no specific treatment for argyriasis. However, the patient can somewhat limit the spread of symptoms. This includes the use of sunscreens and special ointments. However, argyriasis reduces the life expectancy of the affected person. The stored silver usually cannot be removed from the body.
When should you go to the doctor?
If a grayish-bluish discoloration of the fingernails is noticed, a doctor should be consulted. This so-called lunulae typically occurs as the first symptom of argyriasis and, in some cases, may be enough to diagnose the condition. If the discoloration spreads to other areas of the skin, especially the neck, face and arms, medical advice is needed. At the latest, if complaints such as night blindness or kidney failure are added, a doctor should clarify the causes and, if necessary, start therapy directly. Other warning signs are silver deposits in the eye (argyrosis), neurological symptoms, seizures, difficulty swallowing and reduced muscle tone. If one or more of these symptoms occur, there is always a medical condition that requires clarification. The physician can determine whether it is argyrias or another disease by performing a biopsy. In addition, the physician will interview the patient and determine if any risk factors are present. People who have had contact with silver salts over long periods of time are particularly susceptible to argyriasis and should consult a physician as soon as the lunulae mentioned at the beginning appear.
Treatment and therapy
Argyriasis is irreversible – there is no known therapy for argyriasis other than trials of laser treatments for the skin, and therapies with large doses of selenium and vitamin E. In addition to the physical signs of argyrie, sufferers also struggle with the stigma of the disease. In the end, various attempts to flush the stored silver out of the body using complexing agents did not show the desired success. Alternatively, light-shielding cosmetic products as well as sunscreen ointments are used to prevent an increase in pigmentation and to cover up any disturbing pigmentation.
Outlook and prognosis
The prognostic outlook for argyriasis is not favorable. According to current scientific and medical standards, there is no single therapeutic option that cures the disease. The damage to the organism is considered irreversible. The sequelae can be treated and therapized in parts. They serve to improve the well-being in everyday life, but the success is mostly moderate. In particular, pain therapy is used to offer the patient an improvement in quality of life. So far, there is no adequate way to remove the absorbed silver from the body. It attaches itself to organs and leads to functional impairments that cannot be avoided. Newest method approaches try laser therapy for improvement of skin appearance. This is an attempt to restore the comprehensive function of the skin.Nevertheless, the metal stocks inside the body cannot be minimized via this method. Since the life span shortens with the disease, the goal of treatment in a severe manifestation is to maintain a good and independent lifestyle for as long as possible. Often, therapeutic support helps with coping. Researchers continue to search for a functional way to remove the stored silver from the body. Until a breakthrough is made, the prospect of a cure is minimal.
Prevention
To prevent the development of argyriasis, it is important to consider in advance that handling silver or even ingesting silver in large quantities can be dangerous. Anyone who is occupationally exposed to high levels of silver must be well informed about the risks and should avoid contact for longer than necessary, if only in their own interest.
Aftercare
Argyriasis usually does not require extensive follow-up care by a physician. Once the triggering agent has been discontinued, the arygia should resolve on its own within a short time. Complications or a return of the condition are not expected as long as the triggering agent is avoided. A few weeks after completion of treatment, the appropriate physician should be revisited to verify that the arygia has been completely cured. A further follow-up may take place four to six months after completion of treatment. If complications occur during recovery, the physician must be informed. In the case of chronic blue discoloration that cannot be resolved by the usual measures, other specialists may need to be involved in the treatment. Follow-up care depends on how quickly and effectively the arygia can be treated. Chronic symptoms generally require longer follow-up. i a positive course of argyriasis, in which blue discoloration of the skin quickly resolves, no further follow-up is necessary.
What you can do yourself
Argyriasis cannot be completely cured even with medical treatment. However, the cosmetic discomfort can be alleviated by some home remedies and precautions in everyday life. If discoloration of the skin is detected, the trigger must first be identified and eliminated. In most cases, this requires a change of workplace or even a move. Silverware and preparations containing colloidal silver should be avoided, as this can exacerbate the discoloration of the skin. Light-shielding cosmetics and sunscreen ointments, for example, can help against the skin discoloration itself. In general, the course of the disease can at least be slowed down by avoiding sunlight. Accompanying medical therapy, vitamin E and selenium are also said to have an effect. The corresponding vitamins and trace elements can be supplied, for example, in the form of an appropriate diet or through dietary supplements. Since these measures do not promise any long-term improvement in the skin’s appearance, those affected should learn how to deal with argyriasis. Dealing openly with the disease makes daily life considerably easier. This often also leads to an improvement in the psychological condition. In the long term, the disease must be accepted by those affected, as no sustainable treatment method exists to date.
