Pinto-Almeida Teresa, Lobo Ines, Selores Manuela
Department of Dermatology, Hospital de Santo António, Edifício das Consultas Externas, Rua D. Manuel II s/n, Porto, Portugal.
Dermatol Online J. 2013 Jul 14;19(7):18964.
A 34 year-old man presented with asymptomatic bluish-gray macules on his hands that had developed over the previous 2 years. He was otherwise healthy and was on no regular medication. A detailed clinical history and histologic examination allowed the diagnosis.Histopathologic examination showed deposits of aggregated granules of black pigment in the dermis, localized preferentially around the sweat glands. This was consistent with the deposition of silver salts. Given the absence of systemic complaints or other signs and symptoms, a conservative approach was adopted. The lesions remain unchanged after one year of follow up.The wide range of uses for silver allows exposure to its compounds (metal, soluble and insoluble compounds) through different routes of entry, namely direct contact, ingestion, inhalation, and puncture. [1] This exposure is usually occupational, iatrogenic, or accidental. [1] Argyria is an exceedingly rare disease that became uncommon because medications containing silver are no longer used and occupational protection has evolved significantly. [2] It is caused by the deposition of silver grains in the skin and is further divided into localized and generalized forms, according to the route of entry. [1-4] Localized argyria is caused by direct contact with silver (the tiny particles penetrate the skin through the sweat glands) or puncture. [1, 3, 4] These deposits remain indefinitely in the skin and are characterized by a bluish gray color, more prominent in the photo-exposed areas. [3, 4] In the localized forms, patients usually don't have systemic symptoms and the problem is cosmetic. [1-4] Given the improvement in the safety of working conditions, occupational argyria cases are becoming quite uncommon. [1-4].
一名34岁男性，双手出现无症状的蓝灰色斑疹，已持续2年。他身体健康，未服用常规药物。详细的临床病史和组织学检查得以确诊。组织病理学检查显示真皮中有聚集的黑色色素颗粒沉积，优先聚集在汗腺周围。这与银盐沉积一致。鉴于无全身不适或其他体征和症状，采取了保守治疗方法。随访一年后病变无变化。银的用途广泛，可通过不同途径接触其化合物（金属、可溶性和不溶性化合物），即直接接触、摄入、吸入和穿刺。[1] 这种接触通常是职业性、医源性或意外性的。[1] 银质沉着病是一种极其罕见的疾病，由于含银药物不再使用且职业防护有了显著发展，该病已变得不常见。[2] 它是由银颗粒沉积在皮肤中引起的，根据接触途径进一步分为局限性和全身性形式。[1-4] 局限性银质沉着病是由直接接触银（微小颗粒通过汗腺穿透皮肤）或穿刺引起的。[1, 3, 4] 这些沉积物会永久留在皮肤中，表现为蓝灰色，在暴露于光的部位更明显。[3, 4] 在局限性形式中，患者通常没有全身症状，问题主要是外观方面的。[1-4] 鉴于工作条件安全性的提高，职业性银质沉着病病例变得相当罕见。[1-4]
