We report a woman with acute arsenic poisoning, who developed an erythroder
ma with vesicles and pustules after the ingestion of 8-16 g of sodium arsen
ite, Simultaneously, she presented a herpes simplex virus infection, Skin b
iopsies showed unique features which included multiple small pigment granul
es inside and outside the histiocytes. In our opinion, these findings are c
onsistent with acute arsenic poisoning, and constitute the first histologic
al description of this entity in skin.