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Volume 356:2327-2328 May 31, 2007 Number 22
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Medical Mystery: Skin Discolorations — The Answer

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by Schanz, S.
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To the Editor: The medical mystery in the April 5 issue1 involved a 34-year-old bank employee who presented with black discolorations of the skin (Figure 1A) on all her fingers. The discolorations had developed in the evening after work. A skin-biopsy specimen of the black spots revealed brownish deposits of elemental silver in the corneal layer (Figure 1B), with a fluorescent aspect on the dark-field microscopical examination (Figure 1C), which is typical of elemental silver. Infrared spectroscopy and microanalysis with x-rays showed that some of the bills the patient had been counting (Figure . . . [Full Text of this Article]



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