An 84-year-old man presented to a Hong Kong hospital with complications from a urinary flow obstruction, leaving doctors baffled by a seemingly unrelated grayness of his skin, eyes and nails.
The unusual color was far from new. In fact, its faint ashen hue reportedly appeared five years ago.
Blood tests soon revealed the culprit: silver. At concentrations more than 40 times higher than those in most individuals, the man’s body was positively saturated with the metal, causing it to bead into tiny oxidized granules just beneath his skin in the membranes of his sweat glands, blood vessels and skin fibers.
Known as argyria, the systemic accumulation of silver in body tissues is rare but far from unknown. In extreme cases, individuals may be left with large areas of exposed skin that appear noticeably blue.
Historically, the condition affected craftsmen and miners who worked closely with the metal, but in a number of cases the element was absorbed by medications containing silver for its antimicrobial properties.
Colloidal silver continues to be used without scientific evidence supporting its effectiveness, with the U.S. Food and Drug Administration warning that the ingredient is not currently considered a safe or effective means of treating any disease or condition.
That’s not to say that silver-based ‘treatments’ aren’t readily available around the world and are often marketed as dietary supplements claiming to help expel toxins or support the body’s defenses.
The metal is usually absorbed internally as a charged particle through the lungs, skin or digestive system and is deposited widely as it is transported through the body. Wherever UV radiation from sunlight can reach, the silver ions can capture an electron and transform it into a form that can react to form compounds that reflect a dull gray or blue color.
As the recently published case study reveals, the 84-year-old was treated for a benign prostate tumor, even though his only medication was a common anti-androgen called finasteride, which shouldn’t contain anything remotely like silver.
After working as a waiter for many years, the patient presented no apparent source of silver contamination in his workplace. Without any of his neighbors showing similar changes in skin color, exposure in his home environment was also unlikely.
Fortunately, the condition is unlikely to have a significant impact on the patient’s long-term health. Aside from the subtle cosmetic effects, silver buildup is relatively benign except at the highest concentrations, and at most may affect the absorption of some antibiotics and drugs such as thyroxine.
That said, it would be difficult for the man to get rid of his slate gray tone if he wanted to. Currently, there are no known measures that can eliminate an accumulation of silver from the body.
Where exactly it comes from remains a mystery for now. However, with a diagnosis in his medical record, the patient’s doctors will undoubtedly keep a close eye on his silver status in the coming years.
This case study was published in The New England Journal of Medicine.