Graphite foreign body misdiagnosed as a blue naevus-like localised argyria

Abstract

Pencil-tip injuries, although usually insignificant, have the potential to provoke granulomatous reactions. Other undesirable consequences of such injuries include pigmentation and abscess formation. Despite the rarity of such outcomes, it is important that clinicians are aware of the varying presentations of pencil-tip injury, as this can cause diagnostic uncertainty. Here, we present a case of graphite foreign body granuloma, originally thought to be a blue naevus-like localised argyria. The diagnostic work-up was complicated by the absence of a history of injury with a pencil-tip.