Dartmouth-Hitchcock Medical Center, Department of Pathology and Laboratory Medicine, Lebanon, New Hampshire, USA.
J Cutan Pathol. 2020 Dec;47(12):1205-1210. doi: 10.1111/cup.13851. Epub 2020 Sep 15.
Exposure to silver-containing compounds can result in reversible discoloration of the skin, presenting as an irregular brown or black macule, which can have a clinical appearance similar to melanoma. Both the clinical scenario and the histopathology are unique. Silver nitrate darkens with exposure to light, and the area can appear to change over time. On microscopic examination, there are coarse pigmented granules dispersed throughout the corneal layer, and largely absent from the remainder of the epidermis-although the precise location may depend on the duration of topical exposure. While argyria, its irreversible counterpart, has been well-characterized, only a single source has previously reported the histopathology of transient topical silver nitrate exposure. We present two cases, review the clinical and histopathologic differentials, and detail the distinctive histopathology that enables a diagnosis to be suggested in this clinical mimicker of melanoma.
暴露于含银化合物可导致皮肤可逆性变色，表现为不规则的棕色或黑色斑片，其临床表现类似于黑色素瘤。临床情况和组织病理学均具有独特性。硝酸银在暴露于光线下会变暗，并且该区域的外观可能会随时间发生变化。在显微镜下检查时，可以看到角膜层中散布着粗大的色素颗粒，而表皮的其余部分则基本没有-尽管确切的位置可能取决于局部暴露的持续时间。虽然已经很好地描述了其不可逆的对应物银沉着症，但以前只有一个来源报道了短暂局部硝酸银暴露的组织病理学。我们介绍了两例病例，回顾了临床和组织病理学差异，并详细介绍了可在这种黑色素瘤临床模拟物中做出诊断的独特组织病理学。
