Argyria
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Argyria or argyrosis is a condition caused by excessive exposure to chemical compounds of the element
silver Silver is a chemical element with the symbol Ag (from the Latin ', derived from the Proto-Indo-European ''h₂erǵ'': "shiny" or "white") and atomic number 47. A soft, white, lustrous transition metal, it exhibits the highest electrical ...
, or to silver dust. The most dramatic symptom of argyria is that the
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...
turns
blue Blue is one of the three primary colours in the RYB colour model (traditional colour theory), as well as in the RGB (additive) colour model. It lies between violet and cyan on the spectrum of visible light. The eye perceives blue when ...
or blue-grey. It may take the form of ''generalized argyria'' or ''local argyria''. Generalized argyria affects large areas over much of the visible surface of the body. Local argyria shows in limited regions of the body, such as patches of skin, parts of the
mucous membrane A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It i ...
or the
conjunctiva The conjunctiva is a thin mucous membrane that lines the inside of the eyelids and covers the sclera (the white of the eye). It is composed of non-keratinized, stratified squamous epithelium with goblet cells, stratified columnar epithel ...
. The terms argyria and argyrosis have long been used interchangeably, with argyria being used more frequently. Argyrosis has been used particularly in referring to argyria of the conjunctiva, but the usage has never been consistent and cannot be relied on except where it has been explicitly specified. The term is from the grc, ἄργυρος (''argyros'', 'silver').


Pathophysiology

In humans and other animals, chronic intake of silver products commonly leads to gradual accumulation of silver compounds in various parts of the body. As in photography (where silver is useful because of its sensitivity to light), exposure of pale or colourless silver compounds to sunlight decomposes them to silver metal or
silver sulfide Silver sulfide is an inorganic compound with the formula . A dense black solid, it is the only sulfide of silver. It is useful as a photosensitizer in photography. It constitutes the tarnish that forms over time on silverware and other silver o ...
s. Commonly these products deposit as microscopic particles in the skin, in effect a dark pigment. This condition is known as argyria or argyrosis. Chronic intake also may lead to silver pigments depositing in other organs exposed to light, particularly the
eyes Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and con ...
. In the conjunctiva this is not generally harmful, but it also may affect the lens, leading to serious effects. Localised argyria often results from
topical A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surfaces such as the skin or mucous membranes to treat ailments via a large range of classes ...
use of substances containing silver, such as some kinds of
eye drop Eye drops or eyedrops are liquid drops applied directly to the surface of the eye usually in small amounts such as a single drop or a few drops. Eye drops usually contain saline to match the salinity of the eye. Drops containing only saline ...
s. Generalized argyria results from chronically swallowing or inhaling silver compounds, either for home medicinal purposes, or as a result of working with silver or silver compounds. While silver is potentially toxic to humans at high doses, the risk of serious harm from low doses, given over a short term, is small. Silver is used in some medical appliances because of its anti-microbial nature, which stems from the
oligodynamic effect The oligodynamic effect (from Greek ''oligos'', "few", and ''dynamis'', "force") is a biocidal effect of metals, especially heavy metals, that occurs even in low concentrations. In modern times, the effect was observed by Carl Nägeli, although ...
. Chronic ingestion or inhalation of silver preparations (especially colloidal silver) can lead to argyria in the skin and other organs. This is not life-threatening, but is considered by most to be cosmetically undesirable. The reference dose, published by the
United States Environmental Protection Agency The Environmental Protection Agency (EPA) is an independent executive agency of the United States federal government tasked with environmental protection matters. President Richard Nixon proposed the establishment of EPA on July 9, 1970; it ...
in 1991, which represents the estimated daily exposure that is unlikely to incur an appreciable risk of deleterious effects during a lifetime, is 5 µg/(kg·d). Argyria worsens and builds up as exposure to silver continues, and does not resolve once exposure stops.


History

Since at least the mid-19th century, doctors have known that silver or silver compounds can cause some areas of the skin and other body tissues to turn grey or blue-grey. Argyria occurs in people who ingest or inhale silver in large quantities over a long period (several months to many years). People who work in factories that manufacture silver products can also breathe in silver or its compounds. In the past, some of these workers have become argyric. However, the level of silver in the air and the length of exposure that caused argyria in these workers is not known. Historically, colloidal silver, a
liquid A liquid is a nearly incompressible fluid that conforms to the shape of its container but retains a (nearly) constant volume independent of pressure. As such, it is one of the four fundamental states of matter (the others being solid, gas, ...
suspension of
microscopic The microscopic scale () is the scale of objects and events smaller than those that can easily be seen by the naked eye, requiring a lens or microscope to see them clearly. In physics, the microscopic scale is sometimes regarded as the scale be ...
silver particles, was also used as an internal medication to treat a variety of diseases. In the 1940s, they were overtaken by the use of pharmaceutical antibiotics, such as
penicillin Penicillins (P, PCN or PEN) are a group of β-lactam antibiotics originally obtained from '' Penicillium'' moulds, principally '' P. chrysogenum'' and '' P. rubens''. Most penicillins in clinical use are synthesised by P. chrysogenum usin ...
.


Society and culture

A prominent case involving the ingestion of colloidal silver was that of Stan Jones of
Montana Montana () is a state in the Mountain West division of the Western United States. It is bordered by Idaho to the west, North Dakota and South Dakota to the east, Wyoming to the south, and the Canadian provinces of Alberta, British Columb ...
, a
Libertarian Libertarianism (from french: libertaire, "libertarian"; from la, libertas, "freedom") is a political philosophy that upholds liberty as a core value. Libertarians seek to maximize autonomy and political freedom, and minimize the state's en ...
candidate for the
United States Senate The United States Senate is the upper chamber of the United States Congress, with the House of Representatives being the lower chamber. Together they compose the national bicameral legislature of the United States. The composition and po ...
in 2002 and 2006. The peculiar coloration of his skin was featured prominently in media coverage of his unsuccessful campaign, though Jones contended that the best-known photo was "doctored". Jones promised that he was not using his silvery complexion as a gimmick. His purposeful consumption of colloidal silver was a self-prescribed measure undertaken in response to fears that the
Y2K problem The year 2000 problem, also known as the Y2K problem, Y2K scare, millennium bug, Y2K bug, Y2K glitch, Y2K error, or simply Y2K refers to potential computer errors related to the formatting and storage of calendar data for dates in and after ...
would make antibiotics unavailable, an event that did not occur. He is reported to have said that given the chance to go back, he would do it again. He maintains that his good health, excepting the unusual skin tone, is the result of his use of colloidal silver. In 2007, press reports described Paul Karason, an
American American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, pe ...
man whose entire skin gradually turned
blue Blue is one of the three primary colours in the RYB colour model (traditional colour theory), as well as in the RGB (additive) colour model. It lies between violet and cyan on the spectrum of visible light. The eye perceives blue when ...
after he took a homemade
silver chloride Silver chloride is a chemical compound with the chemical formula Ag Cl. This white crystalline solid is well known for its low solubility in water (this behavior being reminiscent of the chlorides of Tl+ and Pb2+). Upon illumination or heat ...
colloid and used a silver salve on his face in an attempt to treat problems with his
sinuses Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity. The maxillary sinuses are located under the eyes; the frontal sinuses are above the eyes; the ethmoidal sinuses are between the eyes and the spheno ...
,
dermatitis Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved c ...
,
acid reflux Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...
and other issues. At the time of the reports, Karason maintained his belief in silver's effectiveness and continued to take it, albeit in smaller doses. He died in 2013 of a
heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which ma ...
; "a cause of death was not immediately known", but according to Jo Anna Karason, his estranged wife, "Paul Karason had suffered heart problems for years. He was a heavy smoker, despite undergoing
triple bypass surgery Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pai ...
about five years ago". Rosemary Jacobs is a prominent activist against
alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and al ...
. As a child, Jacobs was treated for allergies with nose drops that contained colloidal silver, and developed argyria as a result. Jacobs came to international attention after Paul Karason was on ''
The Today Show ''Today'' (also called ''The Today Show'' or informally, ''NBC News Today'') is an American news and talk morning television show that airs weekdays from 7:00 a.m. to 11:00 a.m. on NBC. The program debuted on January 14, 1952. It ...
'' in 2008. From 2010 to 2013, Jacobs posted about topics in health fraud, particularly
naturopathy Naturopathy, or naturopathic medicine, is a form of alternative medicine. A wide array of pseudoscientific practices branded as "natural", "non-invasive", or promoting "self-healing" are employed by its practitioners, who are known as naturo ...
, on her blog.


Possible implications

Although research is still not definitive, the literature has suggested that argyria can cause a decrement in
kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blo ...
function. Additionally, a lack of
night vision Night vision is the ability to see in low-light conditions, either naturally with scotopic vision or through a night-vision device. Night vision requires both sufficient spectral range and sufficient intensity range. Humans have poor night v ...
may be present. The lack of night vision would most likely be due to damaged rods in the eye, from the exposure to silver or silver dust particles in the ocular region.


See also

* Amalgam tattoo * Bismuthia * Carotenodermia * Chrysiasis *
Methemoglobinemia Methemoglobinemia, or methaemoglobinaemia, is a condition of elevated methemoglobin in the blood. Symptoms may include headache, dizziness, shortness of breath, nausea, poor muscle coordination, and blue-colored skin (cyanosis). Complications ...
, another condition known for causing blue skin coloration


References


External links

*
"Rosemary's Story."
Rosemary Jacobs explains her argyria; includes photographs. Accessed February 24, 2007.

by Akhil Wadhera, MD and Max Fung, MD. ''Dermatology Journal Online.'' Accessed February 24, 1997.
"Blue Man Seeks Acceptance"
about another victim of argyria due to colloidal silver.
"Man Turns Blue"
by Duncan Hooper, telegraph.co.uk, Dec. 21, 2007.
"This Man Turned Blue (video)"
NBC Today Show,
Matt Lauer Matthew Todd Lauer (; born December 30, 1957) is an American former television news personality, best known for his work with NBC News. After serving as a local news personality in New York City on WNBC, his first national exposure was as the ne ...
interview, aired January 7, 2008.
Chemistry behind the ‘blue man’ unlocked"
by Josh Howgego,
Chemistry World ''Chemistry World'' is a monthly chemistry news magazine published by the Royal Society of Chemistry. The magazine addresses current events in world of chemistry including research, international business news and government policy as it affects ...
, 1 November 2012. {{Pigmentation disorders Disturbances of human pigmentation Silver Toxic effects of metals