Beutler Bryce David, Lee Robert A, Cohen Philip R
University of Nevada, Reno School of Medicine, Reno, NV.
Dermatol Online J. 2016 Nov 15;22(11):13030/qt4wm1j7pt.
BackgroundLocalized cutaneous argyria is a rare skin condition caused by direct contact with silver or silver particles. It presents as asymptomatic gray or blue-gray macules that appear similar to blue nevi. Histologic features include brown-colored or black-colored silver granules in the basement membrane and dermis, most commonly surrounding eccrine glands, elastic fibers, and collagen fibrils. The condition is most frequently observed in individuals who are regularly exposed to small silver particles, such as silversmiths and welders. However, localized cutaneous argyria has also been associated with acupuncture needles, silver earrings, and topical medications containing silver nitrate. Although the condition is benign, patients who are concerned about the cosmetic features of localized cutaneous argyria may benefit from laser therapy.PurposeWe describe the clinical and pathologic findings of two women who developed localized cutaneous argyria. We also review the characteristics of other patients with localized cutaneous argyria and summarize the differential diagnosis and treatment options for this condition.Materials and methodsThe features of two women with localized cutaneous argyria are presented. Using PubMed, the following terms were searched and relevant citations assessed: acquired localized argyria, acupuncture, argyria, argyrosis, colloidal silver, cutaneous argyria, and localized cutaneous argyria. In addition, the literature on localized cutaneous argyria is reviewed.ResultsTwo women presented with small, asymptomatic blue-gray macules appearing at sites directly adjacent to ear piercings. A punch biopsy was performed on one woman. Microscopic examination revealed a yellowish-brown colored granular material found adjacent to elastic fibers. Based on correlation of the clinical presentation and histopathologic findings, a diagnosis of localized cutaneous argyria was established. The second woman did not undergo a biopsy. However, the clinical presentation was highly suggestive of localized cutaneous argyria. Both women were reassured of the benign nature of the condition and agreed to return for clinical follow-up if they observed any changes in the appearance of the lesions.
背景
局限性皮肤银质沉着症是一种罕见的皮肤疾病，由直接接触银或银颗粒引起。其表现为无症状的灰色或蓝灰色斑疹，外观类似于蓝痣。组织学特征包括在基底膜和真皮中出现棕色或黑色的银颗粒，最常见于汗腺、弹性纤维和胶原纤维周围。这种情况最常出现在经常接触小银颗粒的个体中，如银匠和焊工。然而，局限性皮肤银质沉着症也与针灸针、银耳环以及含硝酸银的外用药物有关。尽管该病症为良性，但担心局限性皮肤银质沉着症外观的患者可能会从激光治疗中获益。
目的
我们描述了两名患局限性皮肤银质沉着症女性的临床和病理表现。我们还回顾了其他局限性皮肤银质沉着症患者的特征，并总结了该病症的鉴别诊断和治疗选择。
材料与方法
介绍了两名患局限性皮肤银质沉着症女性的特征。使用PubMed搜索了以下术语并评估了相关文献引用：后天性局限性银质沉着症、针灸、银质沉着症、银质沉着病、胶体银、皮肤银质沉着症和局限性皮肤银质沉着症。此外，还回顾了关于局限性皮肤银质沉着症的文献。
结果
两名女性在耳洞紧邻部位出现小的、无症状的蓝灰色斑疹。对其中一名女性进行了打孔活检。显微镜检查发现弹性纤维附近有黄褐色颗粒物质。根据临床表现和组织病理学结果的相关性，确诊为局限性皮肤银质沉着症。第二名女性未进行活检。然而，临床表现高度提示为局限性皮肤银质沉着症。两名女性均被告知该病症的良性性质，并同意如果观察到病变外观有任何变化，回来接受临床随访。
