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
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Leukomelanosis
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Hyper Keratosis

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