Shajil Chandana, Chen Richard J., Mahabal Gauri D.
Christian Medical College and Hospital, Vellore, Tamil Nadu, India
Jefferson-Einstein Healthcare Network
Arsenical keratosis is a precancerous dermatosis observed in patients with chronic arsenic toxicity. This condition is characterized by corn-like, yellowish, hyperkeratotic papules and plaques, primarily affecting the palms and soles. Often, it starts as small areas of hyperkeratosis, which increase in number and size to involve the entire palms and soles. In rare cases, it can spread to the dorsal surfaces of the hands and feet and other parts of the body and may progress to squamous cell carcinoma (SCC). Arsenical keratosis with skin hyperpigmentation is the earliest and most common presenting complaint in chronic arsenic toxicity. Therefore, it plays a crucial role in guiding clinicians toward the early diagnosis and treatment of chronic arsenic toxicity. Apart from benign conditions such as skin hyperpigmentation and Mees' lines in the nails, arsenical keratosis can sometimes coexist with single or multiple lesions of Bowen's disease, basal cell carcinoma, and SCC. Identification and elimination of the source of arsenic exposure are of utmost importance, as these patients are at a high risk of developing multisystem disorders and visceral malignancies.
砷角化病是一种在慢性砷中毒患者中观察到的癌前皮肤病。这种病症的特征是出现鸡眼样、淡黄色、角化过度的丘疹和斑块，主要累及手掌和脚底。通常，它起初表现为小面积的角化过度，随后数量和面积增加，累及整个手掌和脚底。在罕见情况下，它可蔓延至手脚背部及身体其他部位，并可能进展为鳞状细胞癌（SCC）。伴有皮肤色素沉着的砷角化病是慢性砷中毒最早且最常见的主诉。因此，它在指导临床医生对慢性砷中毒进行早期诊断和治疗方面起着关键作用。除了皮肤色素沉着和指甲上的米氏线等良性病症外，砷角化病有时可与鲍恩病、基底细胞癌和鳞状细胞癌的单个或多个病变同时存在。识别并消除砷暴露源至关重要，因为这些患者发生多系统疾病和内脏恶性肿瘤的风险很高。
