Discoloration of the face, neck and hands

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Discoloration of the face, neck and hands
Discoloration of the face, neck and hands

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A 59-year-old man presented with a four-year history of gradual graying of the skin. His medical history was significant for delusional disorder with intermittent periods of active psychosis and hepatitis C. Daily medications included aspirin 325 mg, quetiapine, multivitamin, chondroitin, milk thistle, vitamin B12, and calcium citrate. For the past eight years, the patient had also been ingesting up to one pint a day of a colloidal silver solution for periodontal disease. A distinctive blue discoloration of his face, neck, and dorsal hands was noted. The nails demonstrated a similar discoloration, especially along the lunulae.

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