Video:Arsenical keratosis
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Description
Arsenical keratosis is a pre-cancerous skin condition, frequently the first sign of longterm arsenic poisoning.[1][2]
Signs and symptoms
It typically presents with small yellowy brown, warty, corn-like bumps in the skin.[2]
Other signs1
Frequently affected sites include the palms of hands and soles of feet, and also the ears.[3] They can look like palmar-pits.[3]
Other signs2
The dark marks may look like 'raindrops' and there may be associated Mees' lines across the nails.[4]
Cause
It is sometimes preceded by dark marks in the skin, around 20 to 30 years after exposure to arsenic, usually from a herbal medicine or contaminated water from wells.[2]
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Differential diagnosis
Conditions that may appear similar include actinic keratosis,[2]
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Seborrhoic keratosis
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SCC
and squamous cell carcinoma in situ.[2]
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Management
Management involves prevention of further exposure to arsenic.[1] Smoking cessation and supplementation with vitamins A, C, and E, may help.[1] Other options include cryotherapy, curettage and electrodessication, carbon dioxide laser ablation, topical keratolytic agents, such as salicylic acid or urea, imiquimod cream, topical 5-fluorouracil, oral retinoids, or surgical excision.[1]
Prognosis
Arsenical keratosis may persist indefinitely, and some may develop into invasive squamous cell carcinoma. Metastatic arsenic squamous cell carcinoma and arsenic-induced malignancies in internal organs such as the bladder, kidney, skin, liver, and colon, may result in death.[5]
Epidemiology
Countries with reported environmental arsenic contamination include Bangladesh, India, Taiwan, Mexico, Chile, Argentina, Japan, and China.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Shajil, Chandana; Mahabal, Gauri D. (2024). "Arsenical Keratosis". StatPearls. StatPearls Publishing.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 DE, Elder; D, Massi; RA, Scolyer; R, Willemze (2018). "Premalignant keratoses: Arsenical keratosis". WHO Classification of Skin Tumours. Vol. 11 (4th ed.). Lyon (France): World Health Organization. pp. 52–53. ISBN 978-92-832-2440-2. Archived from the original on 2022-07-11. Retrieved 2022-08-13.
- ↑ 3.0 3.1 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "29. Epidermal nevi, neoplasms, and cysts: Arsenical keratosis". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 643. ISBN 978-0-323-54753-6. Archived from the original on 2024-04-17. Retrieved 2024-04-17.
- ↑ Johnstone, Ronald B. (2017). "31. Tumors of the epidermis". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 514. ISBN 978-0-7020-6830-0. Archived from the original on 2024-04-17. Retrieved 2024-04-17.
- ↑ Tchounwou PB, Centeno JA, Patlolla AK (January 2004). "Arsenic toxicity, mutagenesis, and carcinogenesis--a health risk assessment and management approach" (PDF). Mol. Cell. Biochem. 255 (1–2): 47–55. doi:10.1023/B:MCBI.0000007260.32981.b9. PMID 14971645.