RESUMO
Exogenous pigmentation by silver nitrate is a rare disease whose clinical manifestations appear even years after the contact, making its diagnosis difficult on occasions. It is characterized by the presence of blue-gray macules or plaques on the skin or mucosa in the contact area, sometimes very similar to melanocytic lesions and melanoma, which constitute the main differential diagnosis. We report the case of a male patient from Medellín, Colombia, with a family history of melanoma and the presence of these lesions throughout his body.
La pigmentación exógena por nitrato de plata es una enfermedad poco frecuente, cuyas manifestaciones clínicas pueden aparecer años después del contacto, lo que en ocasiones dificulta su diagnóstico. Se caracteriza por la presencia de máculas o placas azul-grisáceas en la piel o las mucosas de la zona de contacto que, en ocasiones, son muy similares a las lesiones melanocíticas y al melanoma, sus principales diagnósticos diferenciales. Se reporta el caso de un paciente de Medellín, Colombia, con antecedentes familiares de melanoma y presencia de estas lesiones en todo el cuerpo.
Assuntos
Argiria , Melanoma , Argiria/etiologia , Humanos , Masculino , Pigmentação , Nitrato de Prata/toxicidade , PeleAssuntos
Argiria/diagnóstico , Terapias Complementares/efeitos adversos , Refluxo Gastroesofágico/tratamento farmacológico , Prata/efeitos adversos , Argiria/etiologia , Argiria/patologia , Biópsia , Terapias Complementares/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Unhas/efeitos dos fármacos , Unhas/patologiaRESUMO
Despite studies concerning toxic reactions related to amalgam components in the literature, few studies have been devoted to evaluate local noxious effects of amalgam tattoos (AT) on biological tissues. In addition, little is known about activation of inflammatory cells by mucosa-implanted amalgam debris. Tissue reaction to AT depends on the particle size. Human leukocyte antigen DR (HLA-DR) is an activation marker of inflammatory cells associated with antigen presentation. Metallothioneins (MT) are proteins involved with metal detoxication, including mercury and silver. The purpose of the present study was to investigate the immunolocalization of HLA-DR and MT in AT with large or powdered particles. Paraffin-embedded AT tissue blocks were sectioned and subjected to immunohistochemistry for HLA-DR and MT localization. The results demonstrated a dense mononuclear inflammatory infiltrate associated with large and powdered debris and positivity for HLA-DR and MT in inflammatory cells. While blood vessel walls and connective fibers impregnated with powdered particles were negative for HLA-DR, they were positive for MT. In addition, wherever epithelial basement membrane impregnation by powdered amalgam particles was observed, a strong positivity for MT was detected. These findings demonstrate that residual elements of AT still have noxious local effects over tissues.
Assuntos
Amálgama Dentário/efeitos adversos , Antígenos HLA-DR/análise , Metalotioneína/análise , Transtornos da Pigmentação/imunologia , Transtornos da Pigmentação/metabolismo , Argiria/etiologia , Argiria/imunologia , Argiria/metabolismo , Reação a Corpo Estranho , Humanos , Técnicas Imunoenzimáticas , Leucócitos Mononucleares , Mucosa Bucal/química , Tamanho da Partícula , Transtornos da Pigmentação/induzido quimicamenteRESUMO
Se presenta y comenta el caso de un hombre de 64 años, trabajador de la plata desde los 21 años de edad en cual se demonstró una argiria sistémica. Presentaba lesiones en la piel, mucosas y ojos; las biopsias de piel o hígado demonstraron depósitos de plata. Con tal motivo se hace una revisión del tema