Table of ContentsDefinition / general | Clinical features | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images
Cite this page: Rosales C. Arsenic. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorarsenic.html. Accessed December 2nd, 2022.
Definition / general
- Arsenic is a well water contaminant, used in industrial, mining, agricultural (pesticide) and medicinal (chemotherapy) substances (Toxicol Sci 2011;123:305)
- Often causes hyperkeratotic lesions of skin called arsenical keratoses
- Risk factor for Bowen disease, squamous cell carcinoma, basal cell carcinoma and carcinomas of lung, bladder and kidney
- Skin related problems are rare in U.S.
- Acute arsenical dermatitis or long term sequelae as a diffuse erythematous papular or pustular bullous dermatosis that can progress to exfoliative dermatitis
- "Rain drops on a dusty road": hyperpigmented macules with small foci of hypopigmentation and darker hyperpigmentation in trunk, areola and flexural
- Transverse white nail striations
- Palmar and plantar keratoses 2+ years after exposure; may transform to Bowen’s disease, squamous cell carcinoma and superficial basal cell carcinoma
Microscopic (histologic) description
- Thick, compact hyperkeratosis and parakeratosis, resembling hypertrophic actinic keratoses (eMedicine: Arsenical Keratosis [Accessed 24 August 2018])
- Numerous vacuolated keratinocytes without solar elastosis are suggestive
- May have atypia of keratinocytes