II. Pathophysiology
- Silver salt deposition in skin
- Excessive oral silver intake (e.g. Colloidal Silver)
- Historically silver was used for antibacterial properties before Antibiotics were available
- Unfortunately patients still use colloidal silver in a mis-guided self-treatment
- Silver deposits in tissues (including skin) when renal and hepatic excretion is insufficient for intake
- Topical chronic contact exposures (localized blue-gray skin Skin Discoloration)
- Occupational (Silversmith, Welders)
- Jewelry
- Acupuncture needles
- Silver NitrateTattooing
III. Symptoms
- Asymptomatic
IV. Signs
- Permanent blue-gray to bronze discoloration of skin, mucosa
- May be limited to localized dark blue Macules
- May result in generalized gray-blue skin disocoloration
- Darker coloration where skin exposed to light
V. Differential Diagnosis
- See Hyperpigmentation
- See Skin Discoloration
VI. Complications
- Limited to cosmetic effects in most cases
- Seizures
- Liver Injury
- Renal Injury
VII. Management
- Laser Skin Procedures may be effective
- Other treatments are ineffective (e.g. hydroquinone, Penicillamine, Dermabrasion)
VIII. Resources
- Colloidal Silver (Quackwatch)