Arsenic-related Bowen's disease, Palmar keratosis, and skin cancer

Chronic arsenical intoxication can still be found in environmental and indu strial settings. Symptoms of chronic arsenic intoxication include general p igmentation or focal "raindrop" pigmentation of the skin and the appearance of hyperkeratosis of the palms of the hands and soles of the feet. In addi tion to arsenic-related skin diseases including keratosis, Bowen's disease, basal-cell-carcinoma, and squamous-cell carcinoma, there is also an increa sed risk of some internal malignancies. Arsenic-related diseases are common in areas of the world where the drinking water has a high arsenic content. In this paper, we describe a 35-year-old male patient who had arsenic-rela ted keratosis, squamous-cell carcinoma in the palmar area of his left hand, and Bowen's disease on his left thigh. The patient worked in a borax mine for 15 years, so he was exposed to arsenic in drinking water, airborne arse nic in his workplace, and had direct contact. The patient was treated for 1 1 months for arsenic-related keratosis until an axillary lymph node metasta sis occurred; the lesion was excised and diagnosed to be malignant. Bowen's disease was detected when the patient was being treated for cancer. No oth er malignancy was found. The patient is still receiving regular follow-up c are.