Acral keratoses and squamous-cell carcinomas likely associated with arsenic exposure.
Chronic arsenic exposure is known to inducepunctate keratoses with an increased risk ofprimary squamous-cell carcinoma. Drinking wateris currently the major source of arsenic exposureworldwide and is considered one of the mostsubstantial environmental carcinogens. We describethe case of a 61-year-old Hungarian woman withscattered, acral, hyperkeratotic papules and a historyof five palmoplantar squamous-cell carcinomasas well as two other extremity non-melanomaskin cancers. Prior to immigration, she had livedin a county of Southern Hungary that is known tohave elevated concentrations of inorganic arsenicin the drinking water above the World HealthOrganization's current maximum threshold forsafety. To date, this report is the first to describethe phenomenon of palmoplantar squamouscellcarcinomas in a patient from this region andunderscores the importance of vigilant screening inthose individuals who have spent substantial time inhigh-risk regions internationally and domestically.
Ronald O. Perelman Department of Dermatology, NYU School of Medicine, NYU Langone Medical Center.
Amelia K
AK
Hausauer
Rachel
R
Hoffmann
Vitaly
V
Terushkin
Shane A
SA
Meehan
Alisa N
AN
Femia
Miriam Keltz
MK
Pomeranz
D020261:Arsenic Poisoning / Q000150:complications; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D060766:Drinking Water; D005260:Female; D005528:Foot; D005533:Foot Dermatoses / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006229:Hand Dermatoses / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006801:Humans; D006814:Hungary / Q000208:ethnology; D007642:Keratosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology
D060766:Drinking Water