Mehta Sharad, Goyal Urvashi, Gupta Lalit Kumar, Mittal Asit, Khare Ashok Kumar, Balai Manisha, Chapperwal Mahendra
Department of Dermatology, Venereology and Leprosy, R.N.T. Medical College, Udaipur, Rajasthan, India.
Department of Dermatology, Rajmata Vijaya Raje Scindia Government Medical College, Bhilwara, Rajasthan, India.
Indian J Dermatol. 2019 Mar-Apr;64(2):164. doi: 10.4103/ijd.IJD_704_16.
Two adult patients from a village of district Bhilwara, Rajasthan, consulted Skin Department of R. N. T. Medical College and Hospital, Udaipur, with complaints of thickening of the palms and soles and pigmentation of skin with a nonhealing ulcer on the palm. They also had complaints of loss of appetite, abdominal pain, nausea, vomiting, and loose motion. On examination, there were multiple 2-3 mm, keratotic papules on the palms, and soles on the background of diffuse keratoderma. Two irregular nonhealing ulcers were present on the hands which on excisional biopsy revealed squamous cell carcinoma. A generalized mottled pigmentation was present over the trunk and proximal parts of extremities. The clinical presentation was suggestive of arsenicosis. There was history of similar ailment in some of the fellow villagers as well. With the help of health authorities, a survey was conducted in the village and it was found that eight more villagers were suffering from similar kind of illness. The common source of arsenic was explored and found to be increased in drinking water that was taken out through hand pump. The level of arsenic in drinking water was significantly above the WHO safe limit for arsenic.
两名来自拉贾斯坦邦比尔瓦拉区一个村庄的成年患者，前往乌代布尔的R.N.T.医学院和医院皮肤科就诊，主诉手掌和脚底增厚、皮肤色素沉着，手掌上有一个不愈合的溃疡。他们还伴有食欲不振、腹痛、恶心、呕吐和腹泻症状。检查发现，在弥漫性角化病的背景下，手掌和脚底有多个2-3毫米的角化丘疹。手部有两个不规则的不愈合溃疡，切除活检显示为鳞状细胞癌。躯干和四肢近端出现全身性斑驳色素沉着。临床表现提示为砷中毒。一些同村村民也有类似疾病史。在卫生当局的帮助下，对该村庄进行了调查，发现还有另外八名村民患有类似疾病。经调查发现，砷的共同来源是通过手压泵抽取的饮用水，其中砷含量显著高于世界卫生组织规定的砷安全限量。
