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    1 OF 11

    Silver absorption and toxicity evaluation of silver wound dressings in 40 patients with chronic wounds.
    J Eur Acad Dermatol Venereol 2018 May 6. Epub 2018 May 6.
    Department of Dermatology, Nancy University Hospital, France.
    Background: Silver-containing dressings are considered to be safe even though there have been some reports of complications, including argyria and various organ system dysfunctions. Despite the widespread use of silver dressings, little research has been done regarding the absorption and toxicity of silver.

    Objective: We aimed to study the systemic absorption of silver in patients with chronic inflammatory wounds and to determine associated factors of systemic silver absorption and evaluated its association with silver toxicity. Read More

    Contribution of cutlery and serving dishes to the human daily intake of silver An in vitro assessment.
    Ann Biol Clin (Paris) 2018 Apr;76(2):165-172
    Université Paris Diderot, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Necker-Enfants Malades, EA2373, Paris Descartes, France.
    Silver cutlery and serving dishes are a potential source of exposure of humans that was never quantified. Release of silver was assessed in vitro in an acidic solution mimicking food fluid in two conditions: i] the JRC guidelines for hot fill conditions with stable high temperature over a 2 hour-period of time, and ii] a more realistic condition with spontaneous progressive decline from 90̊C to ambient temperature over the same period of time. Massive silver 95% strips were exposed to a 5% citric acid solution: i) cooling down from 90̊C to ambient or ii) 70̊C maintained, during 2 hours. Read More

    A case of generalized argyria presenting with muscle weakness.
    Ann Occup Environ Med 2017 2;29:45. Epub 2017 Oct 2.
    Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
    Background: Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness.

    Case Presentation: A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. Read More

    Case Report: In Vivo Confocal Microscopic Appearance of Corneal Argyrosis.
    Optom Vis Sci 2017 Nov;94(11):1066-1069
    1Department of Ophthalmology, The Eye & ENT Hospital of Fudan University, Shanghai, China 2Ophthalmology Department of Zaozhuang Municipal Hospital, Zaozhuang, Shandong, China
    Significance: This report details the natural history of corneal argyrosis over 3 years using in vivo confocal microscopy to document regression of hyperreflective deposits, as well as effects on corneal nerves and endothelial cell morphology.

    Purpose: To report the in vivo confocal microscopic features and clinical characteristics of a case of bilateral corneal argyrosis.

    Case Report: A 52-year-old man referred to us 3 months following cautery of the palpebral conjunctiva of both eyes with a silver nitrate stick was observed over the course of 3 years, during which slit-lamp photography and in vivo confocal microscopy were performed. Read More

    Occupational Argyria of the Nasal Mucosa.
    Head Neck Pathol 2018 Jun 4;12(2):252-254. Epub 2017 Aug 4.
    Otorhyniloaryngology Unit, Civitanova Marche General Hospital, Civitanova Marche, Italy.
    A biopsy specimen from the nasal mucosa of a 37-year-old man disclosed a subepithelial accumulation of black granules mainly running parallel to the surface in the absence of any inflammatory infiltrate. Since the mucosal pigment was negative with Perls' stain and resisted to melanin bleach, an exogenous pigmentation was suspected. The biopsy specimen had been taken because of a diffuse steel-blue pigmentation of the nasal mucosa, incidentally discovered during routine clinical examination. Read More

    Antibacterial efficacy of poly(vinyl alcohol) composite nanofibers embedded with silver-anchored silica nanoparticles.
    J Biomed Mater Res B Appl Biomater 2018 Apr 15;106(3):1121-1128. Epub 2017 May 15.
    Nano Fusion Technology Research Lab, Division of Frontier Fibers, Institute for Fiber Engineering (IFES), Interdisciplinary Cluster for Cutting Edge Research (ICCER), Shinshu University 3-15-1, Tokida, Ueda, Nagono, 386-8567, Japan.
    Silver has been widely used as an effective antibacterial agent especially for treating burns and wounds. However, release of silver from materials often arouse side effects due to toxicity of silver towards mammalian cells. Argyria and argyrosis are well known problems of acute toxicity of silver towards human body. Read More

    Ocular Argyrosis Mimicking Conjunctival Melanoma.
    Cornea 2017 Jun;36(6):747-748
    *Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY; †Department of Ophthalmology, Weill Cornell Medical College, New York, NY; ‡Department of Pathology, Dermatopathology Service, Memorial Sloan-Kettering Cancer Center, New York, NY; and §Pathology and Laboratory Services, Duke University Health System, Durham, NC.
    Purpose: To present a novel case of ocular argyrosis mimicking conjunctival melanoma.

    Methods: A 48-year-old man who is a jewelry manufacturer presented with raised pigmented lesions in the inferior fornices of both eyes. Brown-black colored, follicle-like, masses were observed in both fornices. Read More

    Silver-Containing Hydroxyapatite Coating Reduces Biofilm Formation by Methicillin-Resistant In Vitro and In Vivo.
    Biomed Res Int 2016 26;2016:8070597. Epub 2016 Dec 26.
    Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan.
    Biofilm-producing bacteria are the principal causes of infections associated with orthopaedic implants. We previously reported that silver-containing hydroxyapatite (Ag-HA) coatings exhibit high antibacterial activity against methicillin-resistant (MRSA). In the present study, we evaluated the effects of Ag-HA coating of implant surfaces on biofilm formation. Read More

    Antimicrobial coated implants in trauma and orthopaedics-A clinical review and risk-benefit analysis.
    Injury 2017 Mar 21;48(3):599-607. Epub 2016 Dec 21.
    Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen-Marburg, Campus Giessen, Rudolf-Buchheim-Str. 7, Germany. Electronic address:
    Implant-associated infections remain a major issue in orthopaedics and antimicrobial functionalization of the implant surface by antibiotics or other anti-infective agents have gained interest. The goal of this article is to identify antimicrobial coatings, for which clinical data are available and to review their clinical need, safety profile, and their efficacy to reduce infection rates. PubMed database of the National Library of Medicine was searched for clinical studies on antimicrobial coated implants for internal fracture fixation devices and endoprostheses for bone surgery, for which study design, level of evidence, biocompatibility, development of resistance, and effectiveness to reduce infection rates were analyzed. Read More

    In vivo reflectance confocal microscopy characterization of silver deposits in localized cutaneous argyria.
    Br J Dermatol 2016 Nov 5;175(5):1052-1055. Epub 2016 Jul 5.
    Department of Dermatology, Hospital del Mar, Passeig Marítim, 25-29, ES-08003, Barcelona, Spain.
    Localized cutaneous argyria is a rare condition secondary to skin deposition of silver following exposure to substances containing this metal. The clinical appearance and dermoscopy findings require deep melanocytic lesions and particularly melanoma metastasis to be ruled out. Silver deposits are usually confirmed by scanning electron microscopy and/or energy-dispersive X-ray spectroscopy. Read More

    Oxidative stress and cytotoxic effects of silver ion in mouse lung macrophages J774.1 cells.
    J Appl Toxicol 2017 04 14;37(4):471-478. Epub 2016 Sep 14.
    Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Japan.
    Silver is commonly used as a disinfectant, and chronic exposure to silver may cause argyria, resulting in a gray-blue discoloration of human skin. However, the mechanism for cellular toxicity of silver has not been well explained. We studied the mode of cell death, the ratio of glutathione disulfide/glutathione, induction of metallothionein and activation of mitogen-activated protein kinases in J774. Read More

    Levels of silver ions in body fluids and clinical results in silver-coated megaprostheses after tumour, trauma or failed arthroplasty.
    Injury 2016 Oct 11;47 Suppl 4:S11-S16. Epub 2016 Aug 11.
    Orthopaedic Oncology Unit, Careggi University-Hospital, Firenze, Italy.
    Introduction: Infection in megaprostheses remains an unsolved problem, with a rate of occurrence ranging from 5% to 12%. Silver coating of medical devices has recently been proposed to reduce infection rate because of the antibacterial effect of silver. This innovation could be particularly interesting for megaprostheses, but few data have been reported in the literature. Read More

    Diagnostic methods in ocular argyrosis: case report.
    Doc Ophthalmol 2016 Oct 8;133(2):129-138. Epub 2016 Jul 8.
    Department of Ophthalmology, School of Medicine in Katowice, Medical University of Silesia, ul. Ceglana 35, 40-514, Katowice, Poland.
    Purpose: The aim of this report is to present a case of a patient, metal foundry worker, who had been exposed to industrial silver salts for over 20 years. It is well established that chronic exposure to silver compounds can cause accumulation of silver deposits in various tissues. This condition is referred to as argyrosis or argyria, whereas changes related to eye tissues are defined as ocular argyrosis. Read More

    Pauci Immune crescentic glomerulonephritis in a patient with T-cell lymphoma and argyria.
    BMC Nephrol 2016 05 17;17(1):49. Epub 2016 May 17.
    UCL Centre for Nephrology, Royal Free London NHS Foundation Trust, Rowland Hill Street, London, NW3 2PF, UK.
    Background: Silver is a transition metal, toxic when ingested in significant amounts, causing argyria (skin deposition) and argyrosis (eye deposition). It is excreted mainly via the gastrointestinal tract with only small amounts eliminated by the kidneys, and rarely have cases of nephrotoxicity due to silver been reported. Here we present the case of a woman who used colloidal silver as an alternative remedy for a T cell lymphoma, who subsequently developed argyria and a pauci-immune crescentic glomerulonephritis with evidence of extensive glomerular basement membrane silver deposition. Read More

    Successful Treatment of Argyria Using the Picosecond Alexandrite Laser.
    Dermatol Surg 2016 Mar;42(3):431-3
    Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts Goldman, Butterwick, Fitzpatrick, Groff & Fabi Cosmetic Laser Dermatology, San Diego, CA Department of Dermatology, University of California, San Diego, California Goldman, Butterwick, Fitzpatrick Groff & Fabi Cosmetic Laser Dermatology, San Diego, California.

    First Clinical Experience With Thermal-Sprayed Silver Oxide-Containing Hydroxyapatite Coating Implant.
    J Arthroplasty 2016 07 23;31(7):1498-503. Epub 2015 Dec 23.
    Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Saga, Japan.
    Background: Prosthetic joint infection is a serious complication of implant therapy. To prevent prosthetic joint infection, we previously reported the features of silver oxide-containing hydroxyapatite (Ag-HA), which was prepared by mixing silver (a metal with antimicrobial activity) with HA. In this study, we evaluated the potential issues of total hip arthroplasty (THA) with an Ag-HA-coated implant. Read More

    Localized cutaneous argyria: Report of two patients and literature review.
    Dermatol Online J 2016 Nov 15;22(11). Epub 2016 Nov 15.
    University of Nevada, Reno School of Medicine, Reno, NV.
    BackgroundLocalized cutaneous argyria is a rare skin condition caused by direct contact with silver or silver particles. It presents as asymptomatic gray or blue-gray macules that appear similar to blue nevi. Histologic features include brown-colored or black-colored silver granules in the basement membrane and dermis, most commonly surrounding eccrine glands, elastic fibers, and collagen fibrils. Read More

    Assessment of sub-chronic, hematological and histopathological toxicities of a herbal combination.
    Pak J Pharm Sci 2015 Nov;28(6):2153-60
    Department of Basic Sciences, College of Science and Health Profession, King Saud bin Abdulaziz University for Health Sciences,Riyadh, KSA.
    The herbal combination under study consists of Withania somnifera, Tribulus terrestris, Mucuna pruriens and Argyria speciosa. Present study is mainly designed to investigate the gross physical, sub-chronic, hematological and histopathological effects of the combination widely used for its stimulating, revitalizing and fertility boosting effects in Pakistan. Sub-chronic, hematological and histopathological outcomes of herbal combination were assessed on 27 albino rabbits weighing from 1000 gm-1500 gm after giving herbal combination for 60 days in two doses 27 and 81 mg/kg against control. Read More

    Argyria after Silver Nitrate Intake: Case Report and Brief Review of Literature.
    Indian J Dermatol 2015 Sep-Oct;60(5):520
    Department of Dermatology, National Institut of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, DF, México.
    Argyria is a condition characterized by pigmentary changes secondary to exposure to silver salts and its accumulation in skin, mucous membranes and annexes, which typically produces blue or gray-blue spots. A case of a male patient 62 years old, previously healthy, who has a blue-gray hyperpigmentation on the face, trunk and upper extremity, affecting sun-exposed areas is presented. He admitted having ingested silver nitrate for 5 years at a rate of 1 bottle per week, with the intent to kill microorganisms in his body. Read More

    Resident Rounds: Part III - Case Report: Argyria – A Case of Blue-Gray Skin.
    J Drugs Dermatol 2015 Jul;14(7):760-1
    Argyria is an uncommon blue-gray pigmentation of the skin (increased in sun-exposed areas), nail unit, and mucous membranes caused by prolonged silver exposure. Commonly occurs in the setting of occupational exposure, silver-containing medications, or systemic absorption from use of silver sulfadiazine on extensive burns/wounds. Recently, there appears to be an increase in the practice of colloidal silver ingestion given the popularity and easy availability of alternative medicines and dietary supplements containing various silver-containing compounds. Read More

    A Case of Argyria and Acute Leukopenia Associated with the Use of an Antimicrobial Soft Silicone Foam Dressing.
    J Burn Care Res 2016 Sep-Oct;37(5):e493-6
    From The Edward G. Hirschman Burn Center, Arrowhead Regional Medical Center, Colton, California.
    Silver has had an important role in preventing burn-related infections for decades. Relatively few side effects is one factor that has led to its wide spread use. Here, the authors present the first case of argyria, acute leukopenia, and possibly acute kidney injury associated with the use of a silver-containing soft silicone foam dressing. Read More

    Diffractive microscopy in dermatopathology.
    J Cutan Pathol 2016 Jan 8;43(1):18-23. Epub 2015 Oct 8.
    Ackerman Academy of Dermatopathology, New York, NY, USA.
    Diffraction is the process by which a beam of light is spread out as a result of passing through a narrow aperture or across an edge. Light diffraction can be produced by closing the aperture diaphragm beyond the recommended setting, by flipping the condenser cone down, or by using an opaque object such as the microscopist's hand to block the column of light and force it to bend around the edge. Any of these techniques results in greater refractility of objects in the path of the light. Read More

    Interaction evaluation of silver and dithizone complexes using DFT calculations and NMR analysis.
    Spectrochim Acta A Mol Biomol Spectrosc 2015 12;149:830-8. Epub 2015 May 12.
    National Nanotechnology Center, National Science and Technology Development Agency (NSTDA), 111 Thailand Science Park, Khlong Luang, Pathum Thani 12120, Thailand.
    Silver has distinct antibacterial properties and has been used as a component of commercial products with many applications. An increasing number of commercial products cause risks of silver effects for human and environment such as the symptoms of Argyria and the release of silver to the environment. Therefore, the detection of silver in the aquatic environment is important. Read More

    1064 nm Q-switched Nd:YAG laser for the treatment of Argyria: a systematic review.
    J Eur Acad Dermatol Venereol 2015 Nov 6;29(11):2100-3. Epub 2015 Apr 6.
    University of Miami Miller School of Medicine, Department of Dermatology and Cutaneous Surgery, Miami, USA.
    Argyria is a benign skin disease characterized by blue to slate-grey discoloration that is caused by deposition of silver granules in the skin and/or mucus membranes as a result of long-term ingestion of ionized silver solutions or exposure to airborne silver particles. The skin discoloration can be generalized or localized and is exacerbated by sunlight. The skin discoloration is usually permanent, and until recently, there has been no effective treatment for argyria. Read More

    Argyria resulting from chronic use of colloidal silver in a patient presenting for colonoscopy.
    A A Case Rep 2014 Sep;3(6):73-5
    From the U.S. Army Graduate Program in Anesthesia Nursing, U.S. Army Medical Department Center and School, Fort Sam Houston, Texas.
    An elderly male with a history of argyria caused by chronic ingestion of colloidal silver presented for elective colonoscopy. The patient's skin was a profound blue-gray color that caused concern among staff until his condition was identified through his medical and medication history. Colonoscopy and anesthesia proceeded without incident. Read More

    Silver-resistance, allergy, and blue skin: truth or urban legend?
    Burns 2014 Dec;40 Suppl 1:S19-23
    Department of General Surgery, CHRISTUS St. Vincent Regional Medical Center, Santa Fe, NM, United States. Electronic address:
    Medical and non-medical uses of silver are increasing. While the health benefits of silver therapy are widely claimed, few studies address the possible side effects of resistance, allergy, or skin discoloration. In this manuscript, a review of silver absorption, mechanism of action, allergy, microbial resistance and skin changes is presented. Read More

    Dermal argyria: Cutaneous manifestation of a megaprosthesis for distal femoral osteosarcoma.
    Indian J Orthop 2014 May;48(3):326-8
    Department of Orthopaedics and Traumatology, School of Medicine, Dokuz Eylül University Inciralti, 35340, Izmir, Turkey.
    We present a patient with dermal argyria as a cutaneous manifestation of a silver-coated megaprosthesis used for a distal femoral osteosarcoma. Histological and electron microscopic analyses also showed silver deposition in the dermis. Read More

    Severe acute radiation dermatitis in a patient with argyria.
    Case Rep Oncol Med 2014 3;2014:154349. Epub 2014 Mar 3.
    Radiation Oncology, Mater Centre, South Brisbane, QLD 4101, Australia ; University of Queensland, St Lucia, QLD 4067, Australia ; Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia.
    Argyria is a rare cutaneous condition due to dermal silver deposition leading to irreversible blue-grey discoloration. Acute radiation dermatitis (RD) is an expected toxicity in patients undergoing radiotherapy but it is unknown to what extent argyria affects the onset and severity of RD. We report a patient with argyria treated with concurrent chemoradiotherapy for Merkel cell carcinoma who experienced an unexpectedly brisk and severe RD during treatment. Read More

    Iatrogenic rhinopharyngeal isolated argyria induced by silver-containing nasal drug.
    J Craniofac Surg 2014 ;25(2):e149-51
    From the *1st ENT Division, Surgical Sciences Department, and †Department of Biomedical Sciences and Human Oncology, University of Turin, Turin, Italy.
    Localized nasal argyria has been reported in 3 published articles as secondary to occupational exposure and involving the anterior part of the nose. No previous cases of such pathology involving the rhinopharynx were described. Here we report the first case of localized argyria of the roof and of the posterior wall of the rhinopharynx secondary to prolonged use of nasal drops containing colloidal silver protein. Read More

    Optical coherence tomography findings in ocular argyrosis.
    Ophthalmic Surg Lasers Imaging Retina 2013 Nov 25;44 Online:E20-2. Epub 2013 Nov 25.
    A 68-year-old Caucasian man with a remote history of daily colloidal silver ingestion presented for ophthalmic examination in which he was noted to have a distinct slate gray skin discoloration. Funduscopy revealed confluent perimacular drusenoid deposits bilaterally, most of which localized at the level of or anterior to the inner segment ellipsoid band by optical coherence tomography (OCT) imaging. Enhanced depth imaging OCT demonstrated marked choroidal thinning. Read More

    Systematics of the Neotropical genus Catharylla Zeller (Lepidoptera, Pyralidae s. l., Crambinae).
    Zookeys 2014 30(375):15-73. Epub 2014 Jan 30.
    Senckenberg Natural History Collections, Museum of Zoology, Königsbrücker Landstraße 159, 01109 Dresden, Germany.
    The Neotropical genus Catharylla Zeller, 1863 (type species: Crambus tenellus Zeller, 1839) is redescribed. Catharylla contiguella Zeller, 1872, C. interrupta Zeller, 1866 and Myelois sericina Zeller, 1881, included by Munroe (1995) in Catharylla, are moved to Argyria Hübner. Read More

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