title: A case of Bowen's disease and small-cell lung carcinoma: long-term consequences of chronic arsenic exposure in Chinese traditional medicine.
abstract: Chronic arsenic toxicity occurs primarily through inadvertent ingestion of contaminated water and food or occupational exposure, but it can also occur through medicinal ingestion. This case features a 53-year-old lifetime nonsmoker with chronic asthma treated for 10 years in childhood with Chinese traditional medicine containing arsenic. The patient was diagnosed with Bowen's disease and developed extensive-stage small-cell carcinoma of the lung 10 years and 47 years, respectively, after the onset of arsenic exposure. Although it has a long history as a medicinal agent, arsenic is a carcinogen associated with many malignancies including those of skin and lung. It is more commonly associated with non-small-cell lung cancer, but the temporal association with Bowen's disease in the absence of other chemical or occupational exposure strongly points to a causal role for arsenic in this case of small-cell lung cancer. Individuals with documented arsenic-induced Bowen's disease should be considered for more aggressive screening for long-term complications, especially the development of subsequent malignancies.
authors.affiliation: University of Alberta, Faculty of Medicine, Edmonton, Alberta, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Lee
authors.forename: Gwyn
authors.initials: G
authors.lastname: Bebb
mesh_terms: D000284:Administration, Oral; D001151:Arsenic / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy; D001913:Bowen's Disease / Q000139:chemically induced*; D018288:Carcinoma, Small Cell / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008516:Medicine, Chinese Traditional / Q000009:adverse effects*; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000175:diagnosis; D012878:Skin Neoplasms / Q000139:chemically induced*; D013997:Time Factors
chemical_list: D001151:Arsenic