Marshall J P, Schneider R P
Arch Dermatol. 1977 Aug;113(8):1077-9.
A case of generalized argyria secondary to topical silver nitrate use on the oral mucosa is described, and the nature and history of argyria reviewed. The patient has extreme pigmentation of her skin and abdominal viscera, as seen on physical examination, gastroduodenoscopy, and laparotomy. Her use of silver nitrate applicators was uncontrolled by her dentist and pharmacist, and the diagnosis of argyria was not made until 2 1/2 years of heavy usage had passed. Avoidance of similar cases requires the careful scrutiny of silver-containing medicinal usage by all health practitioners and pharmacists. Although the systemic distribution of silver in both elemental and ionic forms can be linked with no systemic toxicity, the resultant pigmentation can be devastating to the patient.
本文描述了一例因口腔黏膜局部使用硝酸银继发全身性银质沉着病的病例，并对银质沉着病的性质和病史进行了回顾。体格检查、胃十二指肠镜检查和剖腹手术显示，该患者皮肤和腹部脏器出现极度色素沉着。她使用硝酸银涂药器的行为未得到牙医和药剂师的管控，在大量使用2年半后才确诊为银质沉着病。为避免类似病例的发生，所有医护人员和药剂师都需要仔细审查含银药物的使用情况。尽管元素态和离子态的银在全身的分布与无全身毒性有关，但由此产生的色素沉着可能会给患者带来严重影响。
