Tarnish tattoos - localised cutaneous argyria from sterling silver in fresh piercings: a case series

Tarnish tattoo is a form of localised cutaneous argyria resulting from the deposition of silver into the skin following exposure to silver jewellery in fresh piercings. This report presents the clinical presentation, diagnosis, and management of 4 female patients with tarnish tattoos on the nose and ear from wearing silver jewellery. All four patients wore silver studs or rings immediately following the piercing. Two of the four patients underwent treatment with nanosecond Q-switched 1064nm Neodymium: Yttrium Garnet laser (QS Nd: YAG) and Q-switched Alexandrite 755nm lasers with minimal improvement. Tarnish tattoos are an under-recognized side-effect of wearing silver jewellery in fresh piercings. The grey-blue discolouration from tarnish tattoos can be challenging to treat with nanosecond QS lasers.