Argyria - Case report
A 70-year-old male rural worker, with a part history of chronic sinusitis and diagnosed with colon adenocarcinoma around one month prior to our observation, was referred to us with widespread grey pigmentation of the skin and nails ( and ). The condition had been asymptomatic for its entire duration (5 years). The patient denied the use of drugs, namely fenotiazines, antimalarials, amiodarone and mynocicline.\nHowever he reported past intranasal application of 10% Silver Vitellinate as a nasal decongestant and antiseptic. He could provide no details of the posology or length of application of this drug, allegedly prescribed by his otolaryngologist. He denied any other forms of contact with silver in his job or elsewhere. We observed diffuse grey pigmentation of the skin (more evident on sun-exposed areas), and also of the oral and labial mucosae and nail plates.\nBlood tests failed to reveal any apparent alterations, namely in electrolytes, or in the metabolism of iron or copper. Histological examination of a biopsy of photoexposed truncal skin revealed an unaltered dermal and epidermal architecture, deposition of extracellular brownish-grey granules at the dermis, sparing the epidermis, arranged in clusters or individually, in a greater amounts at the basal membrane of the eccrine glands ( and ).\nBearing in mind the diagnosis of Argyria, the recent identification of a locally advanced rectum adenocarcinoma, the patient's age and overall clinical status, only measures associated with the aggravating factors were addressed i.e. to limit the amount of unprotected sun exposure. The patient declined further suggested follow up, having decided that his main priority was to care for his cancer.