Black discoloration of palms.

A 30-year-old male patient, presented with black discoloration of both palms of 5 days duration. The lesions started after contact with silver nitrate solution, which the patient had been exposed to occupationally. He was working in a chemical laboratory supplies department. He had washed the area with water but the pigmentation was persisting [Figure 1].

Figure 1

Bilateral black discoloration of palms secondary to contact with silver nitrate solution

Silver nitrate is used in various industries such as photography, mirror plating, and manufacture of some hair dyes. Contact exposure to silver nitrate can lead to black discoloration of the skin. Silver nitrate can diffuse into the epidermis and react with sweat chloride to form silver chloride, which is then reduced by ultraviolet light to form colloidal particles of metallic silver, which appear black in color. The discolorations cannot be removed by washing with water or detergents, but they usually disappear after approximately 1–2 weeks.[12] Chronic systemic exposure to products containing colloidal silver can lead to argyria—characterized by bluish gray discoloration, especially of sun-exposed areas. Here the silver deposition is deeper as compared with that due to skin contact with silver nitrate.[3]

This article highlights the need to consider silver nitrate as a possible cause for skin discoloration.

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