Clinical manifestation

Diffuse, slate-gray pigmentation of the gingiva and oral mucosa, sun-exposed skin, sclera, and nails

Arteritis of the aged

Differential diagnosis

Cyanosis; diffuse melanosis from meta-static melanoma; hyperpigmentation from other drugs, such as minocycline, gold, or phenothiazine derivative


Discontinuation of exposure to silver; avoidance of sun exposure; chelating agents such as dimercaprol (BAL)


Humphreys SD, Routledge PA (1998) The toxicology of silver nitrate. Adverse Drug Reactions & Toxicological Reviews 17(2-3):115-143

Clinical manifestation

Punctate, non-tender, hard, yellowish, often symmetric, corn-like papules, mainly on the palms and soles; pressure points commonly involved; sometimes coalescing to form large, verrucous plaques

Differential diagnosis

Keratosis palmaris et plantaris; clavus; wart; nevoid basal cell carcinoma syndrome; porokeratosis; psoriasis of the palms and soles; lichen planus; Darier disease; Bazex syndrome; pityriasis rubra pila-

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