Faculty mentor/PI email address

jim010@aol.com

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Keywords

Silver sulfadiazine; Silvadene; Argyria; Cutaneous pigmentation; Burn management; Emergency medicine

Date of Presentation

5-6-2026 12:00 AM

Poster Abstract

Silver sulfadiazine (Silvadene) is a topical antimicrobial commonly used in burn management. Although generally well tolerated, excessive or prolonged application may result in cutaneous pigmentation changes due to silver deposition.

Here we present the case of a a 45-year-old woman who presented with diffuse gray-blue facial discoloration five days after sustaining a minor thermal injury. She had been prescribed topical silver sulfadiazine but applied the medication to her entire face and continued use after wound resolution. Physical examination demonstrated asymptomatic hyperpigmented gray-blue macules confined to areas of application. There were no signs of inflammation or systemic involvement. Discontinuation of the medication resulted in near-complete resolution within several days. The clinical presentation was most consistent with localized cutaneous argyria secondary to topical silver sulfadiazine use. Silver deposition within the dermis can produce characteristic blue-gray pigmentation, particularly in sun-exposed areas. Although rare, this adverse effect underscores the importance of appropriate duration and targeted application of topical antimicrobial therapy. Topical silver sulfadiazine may cause reversible facial discoloration when used excessively or beyond wound healing. Clear patient counseling regarding application and duration may reduce unnecessary adverse effects.

Disciplines

Medicine and Health Sciences | Skin and Connective Tissue Diseases | Wounds and Injuries

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May 6th, 12:00 AM

Facial Skin Discoloration After Topical Silver Sulfadiazine: A Case Report

Silver sulfadiazine (Silvadene) is a topical antimicrobial commonly used in burn management. Although generally well tolerated, excessive or prolonged application may result in cutaneous pigmentation changes due to silver deposition.

Here we present the case of a a 45-year-old woman who presented with diffuse gray-blue facial discoloration five days after sustaining a minor thermal injury. She had been prescribed topical silver sulfadiazine but applied the medication to her entire face and continued use after wound resolution. Physical examination demonstrated asymptomatic hyperpigmented gray-blue macules confined to areas of application. There were no signs of inflammation or systemic involvement. Discontinuation of the medication resulted in near-complete resolution within several days. The clinical presentation was most consistent with localized cutaneous argyria secondary to topical silver sulfadiazine use. Silver deposition within the dermis can produce characteristic blue-gray pigmentation, particularly in sun-exposed areas. Although rare, this adverse effect underscores the importance of appropriate duration and targeted application of topical antimicrobial therapy. Topical silver sulfadiazine may cause reversible facial discoloration when used excessively or beyond wound healing. Clear patient counseling regarding application and duration may reduce unnecessary adverse effects.

 

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