Arsenical keratoses: Case report from nonendemic area of Amritsar

Abstract

Arsenic occurs naturally in the earth's crust, widely distributed in the environment, in drinking water, used in various industrial, agricultural & medicinal substances & is a occupational hazard for miners and glass workers. Arsenic impairs nucleotide excision repair, affect DNA methylation. Chronic exposure of arsenic leads to arsenical keratosis, which usually presents as multiple hyperkeratotic, punctuate lesions, occurs at sites of friction and trauma especially on palms and soles and on chronically light exposed skin. They resemble Bowen's disease microscopically and may progress to squamous cell carcinoma or basal cell carcinoma. Topical 5-FU, 5% Imiquimod and oral retinoids may be helpful in treating arsenic induced cutaneous lesions. Arsenical keratosis in a patient of non endemic area of Amritsar region, makes this case worth reporting.

Keywords

• arsenic
• arsenical keratoses
• bowen's disease