| Argyria | |
|---|---|
| Classification and external resources | |
| ICD-10 | T56.8, L81.8 (ILDS L81.854) |
| ICD-9 | 985.8 |
| DiseasesDB | 29790 |
| eMedicine | derm/595 |
| MeSH | D001129 |
Argyria (ISV from Greek: ἄργυρος argyros silver + -ia) is a condition caused by improper exposure to chemical forms of the element silver, silver dust, or silver compounds.[1] The most dramatic symptom of argyria is that the skin becomes blue or bluish-grey colored. Argyria may be found as generalized argyria or local argyria. Argyrosis is the corresponding condition related to the eye.
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In animals and humans, silver accumulates in the body over time.[2] Chronic intake of silver products can result in an accumulation of silver or silver sulfide particles in the skin. As in photography (where silver is used due to its reactivity with light), these particles in the skin darken with exposure to sunlight, resulting in a blue or gray discoloration of the skin. This condition is known as argyria. Chronic ingestion of silver can similarly lead to an accumulation of silver in the eye (argyrosis) and in other organs.[3] Localized argyria can occur as a result of topical use of substances containing silver, while generalized argyria results from the chronic ingestion of such substances.[4] Argyria is generally believed to be irreversible, with the only practical method of minimizing its cosmetic disfigurement being to avoid the sun,[5] but laser therapy has been used to treat it with satisfactory cosmetic results.[6][7][8] The Agency for Toxic Substances and Disease Registry (ATSDR) describes argyria as a "cosmetic problem",[9] which is not harmful, but it is mildly disfiguring and thus some people find it to be socially debilitating.[10][11]
Generally, "silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure,"[3] when silver or silver compounds are used in the treatment of external infections or in medical appliances. Lansdown states that "Chronic ingestion or inhalation of silver preparations (especially colloidal silver) can lead to deposition of silver metal/silver sulphide particles in the skin (argyria), eye (argyrosis) and other organs. These are not life-threatening conditions but cosmetically undesirable.” This view is supported by the Agency for Toxic Substances and Disease Registry (ATSDR)[12][13] and other authorities.[3][14] One death has been reported in the medical literature which the authors felt was due to silver toxicity. In that case, a 71-year-old man developed status epilepticus after repeated oral ingestion of colloidal silver.[15] The reference dose, published by the United States Environmental Protection Agency in 1991, which recommends the estimated daily exposure which is unlikely to incur an appreciable risk of deleterious effects during a lifetime, is 5 µg/kg/d; meaning 5 microgram of silver per kilogram of weight per person each day – about 1 liter of 10 ppm colloidal silver per month for a 66 kg person.[16]
The name also has ties to Greek Mythology. In this myth, Argyris—a peasant born of miller and a shepherd's daughter—was stricken with silver skin. He was said to have been born on the battle field and carried to safety in a silver shield. Throughout his life he would endure any number of hardships to gain silver effects. At some point during his travels, he was told of the silver great-helm of Athena. The rumor was enough for him to set out on a quest to obtain this great-helm. He scaled Mt. Olympus, naked, carrying only a silver shield and sword. He then found a way into Athena's bed chamber, bedded her, and lifted the great-helm. When he returned to the land of mortals, he became a braggart. The Gods were infuriated by his impudence and cursed him to forever have the marking of his greed: Silver Skin.
Since at least the early part of the 20th century, doctors have known that silver or silver compounds can cause some areas of the skin and other body tissues to turn gray or blue-gray. 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 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 discontinued due to both the development of safe and effective modern antibiotics and concern about argyria and other side effects of silver products.[17][18]
Since the 1990s, "colloidal silver" has been marketed as an alternative medicine product, with unsubstantiated, and in some jurisdictions illegal, claims of effectiveness. Medical authorities advise against the use of such colloidal silver preparations, as does the published medical literature, because of their lack of proven effectiveness and the risk of side effects.[19][20]
Colloidal silver preparations primarily deliver inactive metallic silver, rather than the active microbicidal silver ion.[5] There is no scientific evidence to support the effectiveness of colloidal silver in vivo. Some in vitro studies demonstrate an anti-bacterial effect of colloidal silver,[21] although one study in 2004 of a colloidal silver solution marketed on the Internet showed no such antimicrobial activity.[22] Most recently are claims that nano-colloidal silver products do not cause argyria, this has neither been proven nor disproven due to the lack of independent study either way.
A prominent case was that of Stan Jones of Montana, a Libertarian candidate for the United States Senate in 2002 and 2006. Jones acquired argyria through consumption of a home-made silver product that he made due to fears that the Year 2000 problem would make antibiotics unavailable.[23] The peculiar colouration of his skin was featured prominently in media coverage of his unsuccessful campaign, though Jones contends that the best-known photo was "doctored".[23] Jones promised that he was not using his silvery complexion as a gimmick. He continues to promote the use of colloidal silver as a home remedy.[23] He has said that his good health, excepting the unusual skin tone, is the result of his use of colloidal silver.[23]
On December 20, 2007 the world press published stories about Paul Karason, a Californian man whose entire skin gradually turned blue after consuming colloidal silver made by himself with distilled water, salt and silver, and using a silver salve on his face in an attempt to treat problems with his sinus, dermatitis, acid reflux, and other issues. This happened because he drank gallons of colloidal silver per week for years.[24][25][26]
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