Pardo-Peret P, Sans-Sabrafen J, Boleda Relats M
Med Clin (Barc). 1979 Nov 25;73(9):386-8.
A case of argyriasis in a 45-year-old woman is reported. When the patient was 34 she took for a period of 25 months a silver-containing pharmacological product (colloidal silicon with 0.5 percent of silver) in order to treat an intestinal dyspepsia with diarrheic episodes. A few months after discontinuing the treatment a cutaneous pigmentation of a greyish-blue color extending over the whole body, developed. There was also discoloration of the nails, hair, and of the oral and gingival mucosae. The differential diagnosis with other conditions that also develop anomalies of cutaneous pigmentation was established. It is thought that the appearance of the silver poisoning is due to different factors such as the quantity of silver intake, the individual sensitivity to the metal, and the greater or lesser period of exposure to sunlight. The importance of the skin biopsy in order to confirm the diagnosis is commented on. Typical pathologic findings include the presence of silver granules in the basal membrane of sudoriparous glands, around the pilosebaceous follicles, and in the connective tissue. Lastly, the authors insist on the necessity to avoid the prescription of silver-salt containing drugs as far as possible, since the cutaneous pigmentation is irreversible.
报告了一例45岁女性的银质沉着病病例。患者34岁时，为治疗伴有腹泻发作的肠道消化不良，服用含银的药物产品（含0.5%银的胶体硅）达25个月。停药几个月后，全身出现了灰蓝色的皮肤色素沉着。指甲、头发以及口腔和牙龈黏膜也出现了变色。与其他同样会出现皮肤色素沉着异常的病症进行了鉴别诊断。认为银中毒的出现归因于不同因素，如银的摄入量、个体对该金属的敏感性以及日照时间的长短。评论了皮肤活检对确诊的重要性。典型的病理发现包括在汗腺基底膜、毛囊皮脂腺周围以及结缔组织中存在银颗粒。最后，作者强调尽可能避免开具含银盐药物的必要性，因为皮肤色素沉着是不可逆的。
