How arsenicosis develops?
History of exposure to and consumption of arsenic contaminated water (>0.05mg/L) for a period exceeding 6 months help develop arsenicosis.
Signs and Symptoms of Arsenicosis
Characteristics Skin Manifestations:
1. Pigmentation changes in skin and/or mucous membrane, for example:
- Melanosis
- Leukomelanosis
2. Hyperkeratinization of skin
Keratosis (hyperkeratosis) – thickening of the skin and appearance of papule or nodules that can both be further sub-categorized as follows:
- Mild- slight thickening or minute papules (less than 2mm) on the palms and soles, often associated with grit like texture, that may be primarily detectable by palpation
- Moderate- multiple raised keratosis (>2 to 5 mm) appearing mainly or exclusively in a symmetric distribution
- Severe- large discrete or confluent keratotic elevations (>5 mm) on palms and soles, with nodular or wart like or horny appearance.
- Diffuse thickening of palms and soles alone or in combination with keratotic nodules
Common Non-Dermatological/Systemic manifestations:
- Weakness/asthenia
- non-specific portal hypertension
- conjunctival congestion (conjunctivitis)
- portal hypertension
- respiratory illnesses, e.g. chronic cough, bronchitis, asthma, etc.
- peripheral neuropathy e.g. tingling, numbness, burning sensation & pain.
Complications
- non-pitting oedema
- peripheral vascular disease (gangrene)
- chronic ulcers
- Bowen’s disease (pre-malignant skin condition)
- squamous cell carcinoma
- basal cell carcinoma
- hepatopathy
- nephropathy
- cancer of internal organs, e.g. urinary bladder, lung, prostate, etc.
- adverse pregnancy outcomes (spontaneous abortion, still birth, miscarriage, etc.)
- diabetes mellitus
- hypertension

Bowen's Disease

Squamous Cell Carcinoma

Basal Cell Carcinoma