Skin nonmelanocytic tumor
Premalignant / in situ
Arsenical keratosis
Author: Cecilia Rosales, M.D.
Last author update: 1 July 2011
Last staff update: 26 April 2024
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Arsenic [title] skin
Table of Contents
Definition / general | Clinical features | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Rosales C. Arsenical keratosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorarsenic.html. Accessed December 23rd, 2024.
Definition / general
- Arsenic is a well water contaminant, used in industrial, mining, agricultural (pesticide) and medicinal (chemotherapy) substances (Toxicol Sci 2011;123:305)
- Often causes hyperkeratotic lesions of skin called arsenical keratoses
- Risk factor for Bowen disease, squamous cell carcinoma, basal cell carcinoma and carcinomas of lung, bladder and kidney
- Skin related problems are rare in U.S.
Clinical features
- Acute arsenical dermatitis or long term sequelae as a diffuse erythematous papular or pustular bullous dermatosis that can progress to exfoliative dermatitis
- "Rain drops on a dusty road": hyperpigmented macules with small foci of hypopigmentation and darker hyperpigmentation in trunk, areola and flexural
- Transverse white nail striations
- Palmar and plantar keratoses 2+ years after exposure; may transform to Bowen’s disease, squamous cell carcinoma and superficial basal cell carcinoma
Microscopic (histologic) description
- Thick, compact hyperkeratosis and parakeratosis, resembling hypertrophic actinic keratoses (eMedicine: Arsenical Keratosis [Accessed 24 August 2018])
- Numerous vacuolated keratinocytes without solar elastosis are suggestive
- May have atypia of keratinocytes
Microscopic (histologic) images
Images hosted on other servers:
Left: normal;
right: hyperkeratotic
skin due to arsenic
