Case: A 70-year-old male rural worker, with a part history of chronic sinusitis and diagnosed with colon adenocarcinoma around one month prior to our observation, was referred to the Dermatology section with widespread grey pigmentation of the skin and nails (Image 1 and 2). Case History: The condition had been asymptomatic for its entire duration (5 years). The patient denied the use of drugs, namely fenotiazines, antimalarials, amiodarone and minocycline. However, he reported past intranasal application of 10% Silver Vitellinate as a nasal decongestant and antiseptic.
He could provide no details of the posology or length of application of this drug, allegedly prescribed by his otolaryngologist. He denied any other forms of contact with silver in his job or elsewhere. Dermatologists observed diffuse grey pigmentation of the skin (more evident on sun-exposed areas), and also of the oral…
