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. 2018 Mar 30;2018:bcr2017222645. doi: 10.1136/bcr-2017-222645

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© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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(A) Squamous cell carcinomas occurring at the right calcaneal sole and right hypothenar palmar hand. (B) Squamous cell carcinoma, right axilla. (C) Squamous cell carcinoma, right inguinal. (D) Squamous cell carcinoma, perianal. (E) Arsenical keratosis with palmar hyperkeratosis and hyperpigmentation, left hand. (F) Traditional medicine formulation, which could be described as crude black balls, were taken at 5 units two times a day; each ball contains approximately 1.05 mg of arsenic based on a quantity of 100 analysed.