Skip to main content
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 1999 Aug;107(8):687–689. doi: 10.1289/ehp.107-1566498

Arsenic-related Bowen's disease, palmar keratosis, and skin cancer.

M Cöl 1, C Cöl 1, A Soran 1, B S Sayli 1, S Oztürk 1
PMCID: PMC1566498  PMID: 10417369

Abstract

Chronic arsenical intoxication can still be found in environmental and industrial settings. Symptoms of chronic arsenic intoxication include general pigmentation or focal "raindrop" pigmentation of the skin and the appearance of hyperkeratosis of the palms of the hands and soles of the feet. In addition to arsenic-related skin diseases including keratosis, Bowen's disease, basal-cell-carcinoma, and squamous-cell carcinoma, there is also an increased risk of some internal malignancies. Arsenic-related diseases are common in areas of the world where the drinking water has a high arsenic content. In this paper, we describe a 35-year-old male patient who had arsenic-related keratosis, squamous-cell carcinoma in the palmar area of his left hand, and Bowen's disease on his left thigh. The patient worked in a borax mine for 15 years, so he was exposed to arsenic in drinking water, airborne arsenic in his workplace, and had direct contact. The patient was treated for 11 months for arsenic-related keratosis until an axillary lymph node metastasis occurred; the lesion was excised and diagnosed to be malignant. Bowen's disease was detected when the patient was being treated for cancer. No other malignancy was found. The patient is still receiving regular follow-up care.

Full text

PDF
687

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arbesman H., Ransohoff D. F. Is Bowen's disease a predictor for the development of internal malignancy? A methodological critique of the literature. JAMA. 1987 Jan 23;257(4):516–518. [PubMed] [Google Scholar]
  2. Bowra G. T., Duffield D. P., Osborn A. J., Purchase I. F. Premalignant and neoplastic skin lesions associated with occupational exposure to "tarry" byproducts during manufacture of 4,4'-bipyridyl. Br J Ind Med. 1982 Feb;39(1):76–81. doi: 10.1136/oem.39.1.76. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brown K. G., Guo H. R., Kuo T. L., Greene H. L. Skin cancer and inorganic arsenic: uncertainty-status of risk. Risk Anal. 1997 Feb;17(1):37–42. doi: 10.1111/j.1539-6924.1997.tb00841.x. [DOI] [PubMed] [Google Scholar]
  4. Dobson R. L., Young M. R., Pinto J. S. Palmar keratoses and cancer. Arch Dermatol. 1965 Nov;92(5):553–556. [PubMed] [Google Scholar]
  5. Fierz U. Katamnestische Untersuchungen über die Nebenwirkungen der Therapie mit anorganischem Arsen bei Hautkrankheiten. Dermatologica. 1965;131(1):41–58. [PubMed] [Google Scholar]
  6. Hsueh Y. M., Cheng G. S., Wu M. M., Yu H. S., Kuo T. L., Chen C. J. Multiple risk factors associated with arsenic-induced skin cancer: effects of chronic liver disease and malnutritional status. Br J Cancer. 1995 Jan;71(1):109–114. doi: 10.1038/bjc.1995.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hsueh Y. M., Chiou H. Y., Huang Y. L., Wu W. L., Huang C. C., Yang M. H., Lue L. C., Chen G. S., Chen C. J. Serum beta-carotene level, arsenic methylation capability, and incidence of skin cancer. Cancer Epidemiol Biomarkers Prev. 1997 Aug;6(8):589–596. [PubMed] [Google Scholar]
  8. Jaafar R., Omar I., Jidon A. J., Wan-Khamizar B. W., Siti-Aishah B. M., Sharifah-Noor-Akmal S. H. Skin cancer caused by chronic arsenical poisoning--a report of three cases. Med J Malaysia. 1993 Mar;48(1):86–92. [PubMed] [Google Scholar]
  9. Lever L. R., Farr P. M. Skin cancers or premalignant lesions occur in half of high-dose PUVA patients. Br J Dermatol. 1994 Aug;131(2):215–219. doi: 10.1111/j.1365-2133.1994.tb08494.x. [DOI] [PubMed] [Google Scholar]
  10. Lindelöf B., Sigurgeirsson B. PUVA and cancer: a case-control study. Br J Dermatol. 1993 Jul;129(1):39–41. doi: 10.1111/j.1365-2133.1993.tb03308.x. [DOI] [PubMed] [Google Scholar]
  11. Lüchtrath H. The consequences of chronic arsenic poisoning among Moselle wine growers. Pathoanatomical investigations of post-mortem examinations performed between 1960 and 1977. J Cancer Res Clin Oncol. 1983;105(2):173–182. doi: 10.1007/BF00406929. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Maier H., Schemper M., Ortel B., Binder M., Tanew A., Hönigsmann H. Skin tumors in photochemotherapy for psoriasis: a single-center follow-up of 496 patients. Dermatology. 1996;193(3):185–191. doi: 10.1159/000246243. [DOI] [PubMed] [Google Scholar]
  13. Plesko I., Vlasák V., Kramárová E., Obsitníková A. The role of the registry in the study of relation between cancer and environment experiences from Slovakia. Cent Eur J Public Health. 1993 Jun;1(1):19–24. [PubMed] [Google Scholar]
  14. Rhodes E. L. Palmar and plantar seed keratoses and internal malignancy. Br J Dermatol. 1970 Apr;82(4):361–363. doi: 10.1111/j.1365-2133.1970.tb06833.x. [DOI] [PubMed] [Google Scholar]
  15. Stolman L. P., Kopf A. W., Garfinkel L. Are palmar keratoses a sign of internal malignancy? Arch Dermatol. 1970 Jan;101(1):52–55. [PubMed] [Google Scholar]
  16. Tan S. H., Tham S. N., Goh C. L. Skin cancers at Tertiary Referral Skin Hospital in Singapore. Int J Dermatol. 1995 Nov;34(11):770–776. doi: 10.1111/j.1365-4362.1995.tb04395.x. [DOI] [PubMed] [Google Scholar]
  17. Wang J. D., Li W. E., Hu F. C., Hu K. H. Occupational risk and the development of premalignant skin lesions among paraquat manufacturers. Br J Ind Med. 1987 Mar;44(3):196–200. doi: 10.1136/oem.44.3.196. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES