Argyria

Background:

An 84-year-old man with benign prostatic hyperplasia was admitted for acute kidney injury due to obstructive uropathy and exhibited diffuse slate-gray skin pigmentation for 5 years. His only medication was finasteride, and he had no known silver exposure.

Methods:

Clinical examination revealed gray discoloration of the face, hands, nails, and sclera. Serum silver levels were elevated (423 nmol/L; reference <10). A skin biopsy showed dark granules in sweat glands, pilosebaceous units, blood vessels, and dermal elastic fibers.

Results:

The findings confirmed generalized argyria, an irreversible condition caused by systemic silver deposition. Despite thorough investigation, the source of silver exposure remained unidentified.

Conclusion:

This case highlights argyria as a rare cause of skin discoloration, emphasizing the need for toxicologic evaluation in unexplained pigmentation changes, even without obvious silver exposure history.

Background:

An 84-year-old man with benign prostatic hyperplasia was admitted for acute kidney injury due to obstructive uropathy and exhibited diffuse slate-gray skin pigmentation for 5 years. His only medication was finasteride, and he had no known silver exposure.

Methods:

Clinical examination revealed gray discoloration of the face, hands, nails, and sclera. Serum silver levels were elevated (423 nmol/L; reference <10). A skin biopsy showed dark granules in sweat glands, pilosebaceous units, blood vessels, and dermal elastic fibers.

Results:

The findings confirmed generalized argyria, an irreversible condition caused by systemic silver deposition. Despite thorough investigation, the source of silver exposure remained unidentified.

Conclusion:

This case highlights argyria as a rare cause of skin discoloration, emphasizing the need for toxicologic evaluation in unexplained pigmentation changes, even without obvious silver exposure history.