Tarnish tattoos: localized cutaneous argyria from sterling silver in fresh piercings. A case series.

Tarnish tattoo is a form of localized 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 four 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 1064-nm Nd:YAG laser and Q-switched alexandrite 755-nm lasers, with minimal improvement. Tarnish tattoos are an under-recognized side-effect of wearing silver jewellery in fresh piercings. The blue-grey discoloration from tarnish tattoos can be challenging to treat with nanosecond Q-switched lasers.