Blue-gray discoloration of the skin.

Volume 84, Number 7 www.aafp.org/afp American Family Physician 821 A 76-year-old man with a 110-pack-year smoking history and resultant chronic obstructive pulmonary disease presented for a routine primary care appointment. He appeared to have severe hypoxia because of the generalized blue-gray discoloration of his skin and fingernails (Figures 1 and 2). He had no history of heart disease or alcohol abuse. He had a history of drinking 3 to 4 oz of a colloidal silver solution daily to boost his immune system. After three years, the patient stopped taking the supplement. On physical examination, the patient was breathing comfortably and speaking in full sentences. His oxygen saturation was 95 percent on room air, and he had a barrel chest. Results of routine laboratory tests were normal.