Authors: Jennifer Aileen Ang-Tangtatco, MD, DPDS; Karen Lee Alabado, MD, FPDS and Lalaine Visitacion, MD, FPDS
Arsenic is categorized as a class I human carcinogen by the International Agency for Research on Cancer and chronic exposure to its inorganic form have been associated with a variety of diseases. Its effect on the skin is the most sensitive endpoint of arsenic exposure and dermal manifestations include arsenic keratoses, a premalignant lesion and considered a diagnostic criterion of arsenic toxicity. We report two cases of chronic arsenic poisoning in a father and son who presented with a history of hypo- and hyperpigmented macules and patches over the body and multiple hyperkeratotic papules over the palms and soles, progressing to ulceration. All other family members, except for one, also had the pigmentary changes on the body and palmoplantar hyperkeratosis. Histopathology results of the ulcerated lesions of both patients were consistent with squamous cell carcinoma. Surgical interventions, oral retinoids, and nutritional buildup were done. The patients are being followed up every six months to monitor cancer progression and internal organ involvement. These cases highlight the role of occupational and environmental exposure to arsenic as an important risk factor in developing keratoses and cancer.
Ang-Tangtatco, JA, Alabado, KL & Visitacion, LV. (2017). Squamous cell carcinoma secondary to arsenic keratoses in a father and son. Journal of the Philippine Dermatological Society, 26(1), 69-73.
arsenic, arsenic keratoses, squamous cell carcinoma
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