- There is no definite & specific treatment of Arsenicosis.
- The chelating agents are effective for acute arsenic toxicity. But their use in chronic toxicity still remains questionable.
- The main strategy of arsenicosis management is to cease exposure to arsenic. Exposure to the causative agent can be stopped mainly by cessation of consuming arsenic contaminated water particularly through cooking and/or drinking.
- To enhance the recovery of manifestations of arsenicosis, Vitamin A (beta carotene), Vitamin E and Vitamin C in combination are used. Enough evidence is not available to support the beneficial role of this regimen. However, some studies showed positive results in terms of improving the manifestations of toxicity particularly melanosis and other subjective symptoms.
- Keratolytic ointment like Urea & Salicylic acid is found to be useful in improving the hyperkeratosis.
Manifestation
Stage-0
- Exposed to arsenic
Stage-1 (Mild)
- Pigmentary changes (Early / Late)
- Abnormal Keratinization of skin (Mild / Moderate)
- Conjunctivitis/Conjunctival congestion
- Respiratory illness
Stage-2 (Moderate)
- Pigmentary changes including leukomelanosis
- Severe hyperkeratinization of skin
- Non-pitting oedema of legs
- Peripheral neuropathy
- Nephropathy (early)
- Hepatopathy (early)
Stage-3 (Severe)
- Peripheral vascular disease including gangrene
- Nephropathy (late)
- Hepatopathy (late)
- Cancer (skin, lung, urinary bladder, prostate)
Management
- Stop intake of arsenic contaminated water and take arsenic free safe water
- Stop intake of arsenic contaminated water and take arsenic free safe water.
- Dietary supplementation
- Application of keratolytic (5-10% urea-salicylic acid ointment) for moderate keratosis.
- Symptomatic treatment
- Follow-up and counseling
- Stop intake of arsenic contaminated water and take arsenic free safe water
- Dietary supplementation
- Application of keratolytic (5-20% urea-salicylic acid ointment)
- Cryosurgery / Operative removal of hyperkeratotic lesions
- Symptomatic treatment
- Follow-up and counseling
- Stop intake of arsenic contaminated water and take arsenic free safe water
- Complication-specific management
- Operative treatment
- Chemotherapy &/or radiotherapy for cancers
- Follow-up and counseling