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In animals and humans, chronic consumption of silver can accumulate in the body over a long period of time.<ref name="FungBowen1996">{{cite journal |author=Fung MC, Bowen DL |title=Silver products for medical indications: risk-benefit assessment |journal=Journal of Toxicology. Clinical Toxicology |volume=34 |issue=1 |pages=119–26 |year=1996 |pmid=8632503 |doi=10.3109/15563659609020246}}</ref> Chronic intake of silver products can result in an accumulation of silver or [[silver sulfide]] particles in the skin. As in photography (where silver is used due to its sensitivity to light), these particles in the skin darken with exposure to sunlight, resulting in a blue or gray discoloration of the skin. This condition is known as argyria. Chronic ingestion of silver can similarly lead to an accumulation of silver in the eye (argyrosis) and in other organs.<ref name="Lansdown2006">{{cite journal |author=Lansdown AB |title=Silver in health care: antimicrobial effects and safety in use |journal=Current Problems in Dermatology |volume=33 |issue= |pages=17–34 |year=2006 |pmid=16766878 |doi=10.1159/000093928 |series=Current Problems in Dermatology |isbn=3-8055-8121-1}}</ref> Localized argyria can occur as a result of topical use of substances containing silver, while generalized argyria results from the chronic ingestion of such substances.<ref name="pmid-16021155">{{cite journal |author=Brandt D, Park B, Hoang M, Jacobe HT |title=Argyria secondary to ingestion of homemade silver solution |journal=Journal of the American Academy of Dermatology |volume=53 |issue=2 Suppl 1 |pages=S105–7 |year=2005 |month=August |pmid=16021155 |doi=10.1016/j.jaad.2004.09.026}}</ref> Argyria is generally believed to be irreversible, with the only practical method of minimizing its cosmetic disfigurement being to avoid the sun,<ref name="blue"/> but laser therapy has been used to treat it with satisfactory cosmetic results.<ref>Rhee, DY, Chang, SE, Lee, MW, et al. Treatment of argyria after colloidal silver ingestion using Q-switched 1,064-nm Nd: YAG laser. Dermatol Surg 2008 July 24 [Epub ahead of print]</ref><ref>{{cite journal |author=Geyer O, Rothkoff L, Lazar M |title=Clearing of corneal argyrosis by YAG laser |journal=The British Journal of Ophthalmology |volume=73 |issue=12 |pages=1009–10 |year=1989 |month=December |pmid=2611183 |pmc=1041957 |doi=10.1136/bjo.73.12.1009}}</ref><ref name="pmid16427508">{{cite journal |author=Jacobs R |title=Argyria: my life story |journal=Clinics in dermatology |volume=24 |issue=1 |pages=66–9; discussion 69 |year=2006 |pmid=16427508 |doi=10.1016/j.clindermatol.2005.09.001}}</ref> The Agency for Toxic Substances and Disease Registry ([[ATSDR]]) describes argyria as a "cosmetic problem",<ref>[http://www.atsdr.cdc.gov/tfacts146.html ToxFAQs: Silver]</ref> which is not physically harmful, but it is severely disfiguring.<ref>{{cite journal |doi=10.1001/jama.1935.02760160011004 |url=http://jama.ama-assn.org/cgi/content/summary/104/16/1387 |author=Gaul LE, Staud AH |year=1935 |title=Seventy cases of generalized argyrosis following organic and colloidal silver medication, including a biospectrometric analysis of ten cases |journal=JAMA |volume=104 |issue=16 |pages=1387–90}}</ref><ref>{{cite journal |doi=10.1001/archotol.1940.00660010128013 |url=http://archotol.ama-assn.org/cgi/content/summary/31/1/127 |author=Bryant BL |year=1940 |title=Argyria resulting from intranasal medication: a clinical and experimental study |journal=Archives of Otolaryngology |volume=31 |issue=1 |pages=127–39}}</ref>
In animals and humans, chronic consumption of silver can accumulate in the body over a long period of time.<ref name="FungBowen1996">{{cite journal |author=Fung MC, Bowen DL |title=Silver products for medical indications: risk-benefit assessment |journal=Journal of Toxicology. Clinical Toxicology |volume=34 |issue=1 |pages=119–26 |year=1996 |pmid=8632503 |doi=10.3109/15563659609020246}}</ref> Chronic intake of silver products can result in an accumulation of silver or [[silver sulfide]] particles in the skin. As in photography (where silver is used due to its sensitivity to light), these particles in the skin darken with exposure to sunlight, resulting in a blue or gray discoloration of the skin. This condition is known as argyria. Chronic ingestion of silver can similarly lead to an accumulation of silver in the eye (argyrosis) and in other organs.<ref name="Lansdown2006">{{cite journal |author=Lansdown AB |title=Silver in health care: antimicrobial effects and safety in use |journal=Current Problems in Dermatology |volume=33 |issue= |pages=17–34 |year=2006 |pmid=16766878 |doi=10.1159/000093928 |series=Current Problems in Dermatology |isbn=3-8055-8121-1}}</ref> Localized argyria can occur as a result of topical use of substances containing silver, while generalized argyria results from the chronic ingestion of such substances.<ref name="pmid-16021155">{{cite journal |author=Brandt D, Park B, Hoang M, Jacobe HT |title=Argyria secondary to ingestion of homemade silver solution |journal=Journal of the American Academy of Dermatology |volume=53 |issue=2 Suppl 1 |pages=S105–7 |year=2005 |month=August |pmid=16021155 |doi=10.1016/j.jaad.2004.09.026}}</ref> Argyria is generally believed to be irreversible, with the only practical method of minimizing its cosmetic disfigurement being to avoid the sun,<ref name="blue"/> but laser therapy has been used to treat it with satisfactory cosmetic results.<ref>Rhee, DY, Chang, SE, Lee, MW, et al. Treatment of argyria after colloidal silver ingestion using Q-switched 1,064-nm Nd: YAG laser. Dermatol Surg 2008 July 24 [Epub ahead of print]</ref><ref>{{cite journal |author=Geyer O, Rothkoff L, Lazar M |title=Clearing of corneal argyrosis by YAG laser |journal=The British Journal of Ophthalmology |volume=73 |issue=12 |pages=1009–10 |year=1989 |month=December |pmid=2611183 |pmc=1041957 |doi=10.1136/bjo.73.12.1009}}</ref><ref name="pmid16427508">{{cite journal |author=Jacobs R |title=Argyria: my life story |journal=Clinics in dermatology |volume=24 |issue=1 |pages=66–9; discussion 69 |year=2006 |pmid=16427508 |doi=10.1016/j.clindermatol.2005.09.001}}</ref> The Agency for Toxic Substances and Disease Registry ([[ATSDR]]) describes argyria as a "cosmetic problem",<ref>[http://www.atsdr.cdc.gov/tfacts146.html ToxFAQs: Silver]</ref> which is not physically harmful, but it is severely disfiguring.<ref>{{cite journal |doi=10.1001/jama.1935.02760160011004 |url=http://jama.ama-assn.org/cgi/content/summary/104/16/1387 |author=Gaul LE, Staud AH |year=1935 |title=Seventy cases of generalized argyrosis following organic and colloidal silver medication, including a biospectrometric analysis of ten cases |journal=JAMA |volume=104 |issue=16 |pages=1387–90}}</ref><ref>{{cite journal |doi=10.1001/archotol.1940.00660010128013 |url=http://archotol.ama-assn.org/cgi/content/summary/31/1/127 |author=Bryant BL |year=1940 |title=Argyria resulting from intranasal medication: a clinical and experimental study |journal=Archives of Otolaryngology |volume=31 |issue=1 |pages=127–39}}</ref>


Generally, "silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure,"<ref name="Lansdown2006"/> when silver or silver compounds are used in the treatment of external infections or in medical appliances. Lansdown states that "Chronic ingestion or inhalation of silver preparations (especially colloidal silver) can lead to deposition of silver metal/silver sulphide particles in the skin (argyria), eye (argyrosis) and other organs. These are not life-threatening conditions but cosmetically undesirable.” This view is supported by the Agency for Toxic Substances and Disease Registry (ATSDR)<ref>http://www.atsdr.cdc.gov/tfacts146.html</ref><ref>http://www.atsdr.cdc.gov/toxprofiles/tp146-c1.pdf</ref> and other authorities.<ref name="Lansdown2006"/><ref name="FungBowen1996"/>
Generally, "silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure,"<ref name="Lansdown2006"/> when silver or silver compounds are used in the treatment of external infections or in medical appliances. Lansdown states that "Chronic ingestion or inhalation of silver can lead to deposition of silver metal/silver sulphide particles in the skin (argyria), eye (argyrosis) and other organs. These are not life-threatening conditions but cosmetically undesirable.” This view is supported by the Agency for Toxic Substances and Disease Registry (ATSDR)<ref>http://www.atsdr.cdc.gov/tfacts146.html</ref><ref>http://www.atsdr.cdc.gov/toxprofiles/tp146-c1.pdf</ref> and other authorities.<ref name="Lansdown2006"/><ref name="FungBowen1996"/>
The reference dose, published by the [[United States Environmental Protection Agency]] in 1991, which represents the estimated daily exposure which is unlikely to incur an appreciable risk of deleterious effects during a lifetime, is 5&nbsp;µg/kg/d.<ref name="FungBowen1996"/>
The reference dose, published by the [[United States Environmental Protection Agency]] in 1991, which represents the estimated daily exposure which is unlikely to incur an appreciable risk of deleterious effects during a lifetime, is 5&nbsp;µg/kg/d.<ref name="FungBowen1996"/>


Revision as of 01:17, 11 March 2013

Argyria
SpecialtyEmergency medicine Edit this on Wikidata

Argyria (from Greek: ἄργυρος argyros silver + -ia) is a condition caused by improper exposure to chemical forms of the element silver, silver dust, or silver compounds.[1] The most dramatic symptom of argyria is that the skin becomes blue or bluish-grey colored. Argyria may be found as generalized argyria or local argyria. Argyrosis is the corresponding condition related to the eye.

Biological effect

In animals and humans, chronic consumption of silver can accumulate in the body over a long period of time.[2] Chronic intake of silver products can result in an accumulation of silver or silver sulfide particles in the skin. As in photography (where silver is used due to its sensitivity to light), these particles in the skin darken with exposure to sunlight, resulting in a blue or gray discoloration of the skin. This condition is known as argyria. Chronic ingestion of silver can similarly lead to an accumulation of silver in the eye (argyrosis) and in other organs.[3] Localized argyria can occur as a result of topical use of substances containing silver, while generalized argyria results from the chronic ingestion of such substances.[4] Argyria is generally believed to be irreversible, with the only practical method of minimizing its cosmetic disfigurement being to avoid the sun,[5] but laser therapy has been used to treat it with satisfactory cosmetic results.[6][7][8] The Agency for Toxic Substances and Disease Registry (ATSDR) describes argyria as a "cosmetic problem",[9] which is not physically harmful, but it is severely disfiguring.[10][11]

Generally, "silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure,"[3] when silver or silver compounds are used in the treatment of external infections or in medical appliances. Lansdown states that "Chronic ingestion or inhalation of silver can lead to deposition of silver metal/silver sulphide particles in the skin (argyria), eye (argyrosis) and other organs. These are not life-threatening conditions but cosmetically undesirable.” This view is supported by the Agency for Toxic Substances and Disease Registry (ATSDR)[12][13] and other authorities.[3][2] The reference dose, published by the United States Environmental Protection Agency in 1991, which represents the estimated daily exposure which is unlikely to incur an appreciable risk of deleterious effects during a lifetime, is 5 µg/kg/d.[2]

History

Since at least the early part of the 20th century, doctors have known that silver or silver compounds can cause some areas of the skin and other body tissues to turn gray or blue-gray. 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 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 suspension of microscopic silver particles, was also used as an internal medication to treat a variety of diseases. In the 1940s they were discontinued due to both the development of safe and effective modern antibiotics and concern about argyria and other side effects of silver products.[14][2]

Colloidal silver

Alternative medicine

See also: Medical uses of silver

Since the 1990s, "colloidal silver" has been marketed as an alternative medicine product, with unsubstantiated, and illegal in some jurisdictions, claims of effectiveness. Medical authorities advise against the use of such colloidal silver preparations, as does the published medical literature, because of their lack of proven effectiveness and the risk of side effects.[15][2]

Colloidal silver preparations primarily deliver inactive metallic silver, rather than the active microbicidal silver ion.[5] There is no scientific evidence to support the effectiveness of colloidal silver in vivo. Some in vitro studies demonstrate an anti-bacterial effect of colloidal silver,[16] although one study in 2004 of a colloidal silver solution marketed on the Internet showed no such antimicrobial activity.[17]

Cases

A prominent case was that of Stan Jones of Montana, a Libertarian candidate for the United States Senate in 2002 and 2006. Jones acquired argyria through consumption of a home-made silver product that he made due to fears that the Year 2000 problem would make antibiotics unavailable.[18] The peculiar colouration of his skin was featured prominently in media coverage of his unsuccessful campaign, though Jones contends that the best-known photo was "doctored".[18] Jones promised that he was not using his silvery complexion as a gimmick. He continues to promote the use of colloidal silver as a home remedy.[18] He has said that his good health, excepting the unusual skin tone, is the result of his use of colloidal silver.[18]

On December 20, 2007 the world press published stories about Paul Karason, a Californian man whose entire skin gradually turned blue after consuming colloidal silver made by himself with distilled water, salt and silver, and using a silver salve on his face in an attempt to treat problems with his sinus, dermatitis, acid reflux, and other issues. [19][20]

As a cause of argyria

A 2012 study of silver nanoparticles has indicated that large, regular consumption of colloidal silver particles is a likely causative agent of argyria. The study links such consumption with the creation of the characteristic blue silver sulfide and silver selenide deposits present in reported cases of argyria. This is due to the rapid dissolution of silver nanoparticles in acidic environments, such as the stomach by oxidative dissolution and previous studies have shown that after the dissolution of silver, it can enter cellular environments through complexated proteins. Subsequently, exposure to UV radiation is able to reconvert silver ions to elemental silver spontaneously reforming silver nanoparticles which can be sulfidated to produce the silver sulfide seen in argyria cases. [21]

See also

References

  1. ^ James, William D.; Berger, Timothy G.; Elston, Dirk M.; Odom, Richard B. (2006). Andrews' diseases of the skin: clinical dermatology. Saunders Elsevier. p. 858. ISBN 0-7216-2921-0. OCLC 62736861.
  2. ^ a b c d e Fung MC, Bowen DL (1996). "Silver products for medical indications: risk-benefit assessment". Journal of Toxicology. Clinical Toxicology. 34 (1): 119–26. doi:10.3109/15563659609020246. PMID 8632503.
  3. ^ a b c Lansdown AB (2006). "Silver in health care: antimicrobial effects and safety in use". Current Problems in Dermatology. Current Problems in Dermatology. 33: 17–34. doi:10.1159/000093928. ISBN 3-8055-8121-1. PMID 16766878.
  4. ^ Brandt D, Park B, Hoang M, Jacobe HT (2005). "Argyria secondary to ingestion of homemade silver solution". Journal of the American Academy of Dermatology. 53 (2 Suppl 1): S105–7. doi:10.1016/j.jaad.2004.09.026. PMID 16021155. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  5. ^ a b Okan D, Woo K, Sibbald RG (2007). "So what if you are blue? Oral colloidal silver and argyria are out: safe dressings are in". Advances in Skin & Wound Care. 20 (6): 326–30. doi:10.1097/01.ASW.0000276415.91750.0f. PMID 17538258. Colloidal silver suspensions are solutions of submicroscopic metallic silver particles suspended in a colloid base. These products deliver predominantly inactive metallic silver, not the antimicrobial ionized form. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  6. ^ Rhee, DY, Chang, SE, Lee, MW, et al. Treatment of argyria after colloidal silver ingestion using Q-switched 1,064-nm Nd: YAG laser. Dermatol Surg 2008 July 24 [Epub ahead of print]
  7. ^ Geyer O, Rothkoff L, Lazar M (1989). "Clearing of corneal argyrosis by YAG laser". The British Journal of Ophthalmology. 73 (12): 1009–10. doi:10.1136/bjo.73.12.1009. PMC 1041957. PMID 2611183. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Jacobs R (2006). "Argyria: my life story". Clinics in dermatology. 24 (1): 66–9, discussion 69. doi:10.1016/j.clindermatol.2005.09.001. PMID 16427508.
  9. ^ ToxFAQs: Silver
  10. ^ Gaul LE, Staud AH (1935). "Seventy cases of generalized argyrosis following organic and colloidal silver medication, including a biospectrometric analysis of ten cases". JAMA. 104 (16): 1387–90. doi:10.1001/jama.1935.02760160011004.
  11. ^ Bryant BL (1940). "Argyria resulting from intranasal medication: a clinical and experimental study". Archives of Otolaryngology. 31 (1): 127–39. doi:10.1001/archotol.1940.00660010128013.
  12. ^ http://www.atsdr.cdc.gov/tfacts146.html
  13. ^ http://www.atsdr.cdc.gov/toxprofiles/tp146-c1.pdf
  14. ^ Fung / Wadhera 2005
  15. ^ "Over-the-counter drug products containing colloidal silver ingredients or silver salts. Department of Health and Human Services (HHS), Public Health Service (PHS), Food and Drug Administration (FDA). Final rule". Federal Register. 64 (158): 44653–8. 1999. PMID 10558603. {{cite journal}}: Unknown parameter |month= ignored (help)
  16. ^ Tien DC, Tseng KH, Liao CY, Tsung TT (2008). "Colloidal silver fabrication using the spark discharge system and its antimicrobial effect on Staphylococcus aureus". Medical Engineering & Physics. 30 (8): 948–52. doi:10.1016/j.medengphy.2007.10.007. PMID 18069039. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  17. ^ van Hasselt P, Gashe BA, Ahmad J (2004). "Colloidal silver as an antimicrobial agent: fact or fiction?". Journal of Wound Care. 13 (4): 154–5. PMID 15114827. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  18. ^ a b c d Stan Jones letter
  19. ^ Meet the man with blue skin - Paul Karason | The Daily Telegraph
  20. ^ Feeling Blue Over Skin Color | ABC News
  21. ^ Chemical Transformations of Nanosilver in Biological Environments | ACS Nano
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