Localized cutaneous argyria: two case reports and clinicopathologic review

Area of Science:

• Dermatology
• Pathology
• Toxicology

Background:

• Blue macules can be clinically mistaken for benign pigmented lesions like blue nevi.
• Differential diagnosis is crucial for accurate patient management and treatment.
• Identifying the etiology of pigmented lesions is essential in dermatological practice.

Observation:

• Two patients presented with macules suspicious for blue nevi.
• One patient had no known history of trauma or silver exposure.
• The other patient reported silver exposure over three decades prior.

Findings:

• Microscopic examination revealed dermal brown-black globules, not melanocytic proliferation.
• Scanning electron microscopy and energy dispersive x-ray spectroscopy detected silver and selenium.
• These analyses confirmed localized cutaneous argyria.

Implications:

• Localized cutaneous argyria should be considered in the differential diagnosis of pigmented skin lesions.
• Advanced imaging techniques aid in diagnosing metal deposition disorders.
• Understanding exposure history is vital for diagnosing iatrogenic or environmental dermatoses.