Argyria mimicking a blue nevis: dermoscopy features
A 30-year-old female patient was referred with asymptomatic induration of the right ear lobule. The posterior region of this area of skin presented a 10-mm oval-shaped macule with an intense steel-blue coloration, under which a small nodule was palpable (). The patient remembered experiencing a previous local inflammatory episode generated by a silver earring 25 years ago. Dermoscopy examination of the macule revealed an area comprising blue-grey structures uniformly distributed across a yellow background (). The lesion was composed of the following three structural types: annular structures, short linear structures observed between the former structures, and multiple dots. The distribution of the lesions was homogeneous and of a parallel aspect (Figure 2B). A white area with a radiated aspect was clearly visible in the center of the lesion (). We performed a cutaneous biopsy of the more indurated area and extracted a metallic piece belonging to a silver earring (). The histopathological study revealed the presence of brown-pigmented granules that had accumulated inside the dermic papillae and densely populated the interpapillary dermis over the elastic fibers and vessel walls surrounding the eccrine glands ().