Shannon R L, Strayer D S
Department of Pathology and Laboratory Medicine, University of Texas Medical School, Houston 77030.
Hum Toxicol. 1989 Mar;8(2):99-104. doi: 10.1177/096032718900800203.
We reviewed available literature on the effects of inorganic arsenic on the skin to determine the potential hazards and to collate information regarding dosage and exposure to the incidence of skin cancer. Arsenic intake may result from occupational or medicinal exposure, or from drinking well water in areas with high arsenic levels in the soil. Arsenic causes a variety of benign skin lesions including hyperpigmentation and hyperkeratosis. Some hyperkeratotic lesions and squamous cell carcinomas in situ may progress to invasive carcinoma; other invasive squamous cell carcinomas will develop de novo. These cutaneous squamous cancers may metastasize; mortality is low, but has been reported. Locally invasive but non-metastasizing basal cell carcinomas may arise as well. These lesions occur in a characteristic pattern of distribution and are usually multiple. Observers reporting medicinally administered arsenic have described dose-response relationships between the amount of arsenic ingested and the frequency of various skin lesions. For arsenic found in drinking water, however, there is more controversy regarding the doses and exposure times necessary for cutaneous toxicity.
我们查阅了有关无机砷对皮肤影响的现有文献，以确定潜在危害，并整理有关剂量、暴露情况与皮肤癌发病率的信息。砷的摄入可能源于职业暴露或药物接触，也可能来自土壤中砷含量高的地区的井水饮用。砷会导致多种良性皮肤病变，包括色素沉着和角化过度。一些角化过度病变和原位鳞状细胞癌可能会发展为浸润性癌；其他浸润性鳞状细胞癌则会原发形成。这些皮肤鳞状细胞癌可能会转移；死亡率较低，但有相关报道。也可能会出现局部浸润但不转移的基底细胞癌。这些病变以特征性的分布模式出现，通常为多发。报告药物性砷暴露的观察者描述了摄入砷的量与各种皮肤病变发生频率之间的剂量反应关系。然而，对于饮用水中的砷，关于皮肤毒性所需的剂量和暴露时间存在更多争议。
