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Journal of the American Academy of Dermatology
Volume 46, n° 2
pages 222-227 (février 2002)
Doi : 10.1067/mjd.2002.116227
accepted : 4 April 2001
Localized argyria with pseudo-ochronosis

Leslie Robinson-Bostom, MDa,b, David Pomerantz, MDa, Caroline Wilkel, MDa,c, Russell Mader, MDd, Lisa Lerner, MDe, Raymond Dufresne, MDa, Thomas Flotte, MDe
Providence, Rhode Island, Kingsport, Tennessee, and Boston, Massachusetts 
From the Departments of Dermatologya and Pathology,b Brown University School of Medicine/Rhode Island Hospital, Providence; the Departments of Dermatology and Pathology, Boston University School of Medicine/Roger Williams Hospital, Providencec; Dermatology Associates of Kingsportd; and the Department of Pathology, Harvard University Medical School/Massachusetts General Hospital, Boston.e 


Background: Localized argyria is uncommon and presents clinically as asymptomatic slate gray macules or blue macules resembling blue nevi. Its histopathologic features are usually similar to those of generalized argyria in which silver granules are found most commonly around the eccrine glands, in the walls of blood vessels, and along elastic fibers. Ochre swollen homogenized collagen bundles resembling ochronosis have not been previously described. Objective: The purpose of this study is to report a series of 5 patients with localized argyria with the histologic feature of “pseudo-ochronosis.” In one patient, biopsy was performed on 2 distinct lesions. Methods: All patients underwent skin biopsies for light microscopy and darkfield microscopy. In two patients, the biopsy specimens were analyzed with a mass spectrophotometer; scanning electron microscopy and energy-dispersive x-ray analysis were performed. In one patient, the biopsy specimen was decolorized with 1% potassium ferricyanide in 20% sodium thiosulfate. Results: All 5 patients presented with the typical clinical and histologic features of localized argyria. Ochre swollen and homogenized collagen bundles were seen in all cases. In addition, light microscopy in 4 cases revealed an ellipsoid black globule within a zone of collagen degeneration. Conclusion: The histologic features of localized argyria include swollen and homogenized collagen bundles resembling ochronosis, “pseudo-ochronosis,” which may be more common than previously recognized. (J Am Acad Dermatol 2002;46:222-7.)

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 Funding: None.
 Conflict of interest: None.
 Reprints not available from authors.
 Correspondence: Leslie Robinson-Bostom, MD, Rhode Island Hospital, Department of Dermatology, APC 10, 593 Eddy St, Providence, RI 02903. E-mail:

© 2002  American Academy of Dermatology, Inc. Published by Elsevier Masson SAS@@#104157@@