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An actor with diffuse facial slate-gray pigmentation
( Dae Yeon Kim ) , ( Min Seok Ham ) , ( Ji Hyuck Hong ) , ( Dong Won Lee ) , ( Hyo Hyun Ahn ) , ( Young Chul Kye ) , ( Soo Hong Seo )
UCI I410-ECN-0102-2018-500-004088824
This article is 4 pages or less.

Slate-gray pigmentation is one of the pigmentations that are not familiar to dermatologists. It may be suspected to be caused by systemic accumulation of medication or repetitive contact of heavy metals. Among them, silver is by far the most common form of heavy metal-induced pigmentation seen by dermatologists. It occurs in two forms, local or systemic. Local argyria typically follows the topical use of silver sulfadiazine or silver-containing dressings. Silver-containing cleansing or cream products have been sold by advertising its antimicrobial effect. Histologically, granules of silver are found in basement membranes around adnexal and vascular structures. Sun exposure leads to the silver binding to either sulfur or selenium in the skin, increasing deposition. The deposited silver activates tyrosinase, increasing pigmentation. A 39-year-old man was presented with asymptomatic diffuse slate-gray pigmentation on his face. He had no significant medical history. He was an actor, and he had been washing his face with silver for the last 1 year. We took a skin biopsy under the impression of local argyria and the diagnosis was confirmed by histopathologic findings. We started treatment with a Q-switched 1064-nm neodymium-doped yttrium-aluminum-garnet laser, but he refused continuous treatments because of the pain. Herein, we report an interesting case of an actor who has facial argyria after repetitive silver washing.

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