Arsenic and Cancer

In the entire world, about 200 million people are exposed to arsenic poisoning in groundwater. In Bihar, India, about 50 million people are drinking arsenic contaminated water. Humans are exposed to elevated levels of inorganic arsenic mainly through the consumption of arsenic contaminated groundwater as drinking water and food crops are irrigated with high-arsenic water resources. This has caused various health-related problems in the population like skin diseases, anemia, bronchitis, gastrointestinal problems, hormonal imbalance and cancer. According to recent study, cancer risk is associated with daily consumption of 2 litres of water with inorganic arsenic 50 μg/L has been estimated to be 1/100 denotes that elevated blood arsenic levels in population can lead to cause various diseases including cancer. Skin and several types of internal cancers, including, bladder, kidney, liver, gall bladder, lung, uterus, and prostate, have been found associated with arsenic ingestion. This hospital-based study also correlates the cause of cancer due to arsenic contamination.

Arsenic Keratosis in a Patient from Newfoundland and Labrador, Canada

Background and Objective: Millions of people worldwide suffer from chronic arsenic poisoning due to contaminated drinking water. The devastating effects of chronic arsenic ingestion are multisystem, but depending on the dose and frequency of exposure, may take many years to become clinically apparent. The earliest and most common manifestations are dermatological, and therefore, recognition of hallmark lesions is key. In this report, we describe a suspected case of palmoplantar arsenical keratosis in a patient from Newfoundland, Canada. Methods: Case report and review of relevant literature via PubMed search. Results: A 64-year-old fisherman from rural Newfoundland presented with a 12-year history of hyperkeratotic palmoplantar papules/plaques. The lesions first appeared on the sole of his left foot but gradually extended to involve the sole of his right foot and palms. Numerous violaceous keratotic papules with erosions were observed. Both the patient and his wife were found to have elevated blood arsenic levels, and the arsenic concentration in their artesian well was 14.2 ug/L (maximum acceptable concentration: 10 ug/L). Interestingly, biopsy showed a lichen-sclerosis-like inflammatory pattern that seems to deviate from the classic histologic description. The patient is being treated with oral acitretin, and minor improvement has been noted. Conclusion: It is important to consider arsenic exposure whenever a patient presents with acral hyperkeratosis. Further research is needed to develop more effective treatments for chronic arsenicism and to determine the effects of very low-dose exposure and what truly constitutes a safe level.

Verrucous Carcinoma due to Arsenic Ingestion in a Psoriasis Patient

Background and Objective: Verrucous carcinoma is a rare clinicopathologic entity caused by multifactorial influences. We report here a 64-year-old male patient presenting with a large exophytic mass in the right leg. Results and Conclusion: The patient had a 19-year duration of psoriasis and received various treatments. In his last year of life, he had been taking an illegally produced folk drug with the hope of controlling his psoriasis. However, 6 months after the drug ingestion, many papules appeared on his right leg, which eventually developed into a large tumor in the next few months. The patient died of acute pulmonary embolism only a week after hospitalization, when his tumor was pathologically confirmed as verrucous carcinoma. Later, the folk drug was analyzed and found to contain arsenic. The causative relevance of the tumor with his daily arsenic intake is discussed. Contexte et objectif: Le carcinome verruqueux est une entité clinicopathologique rare, causée par divers facteurs. Nous exposons ici le cas d'un homme de 64 ans, qui a consulté pour une grosse masse exophytique sur la jambe droite. Résultats et conclusions: Le patient souffrait de psoriasis depuis 19 ans et a été soumis à divers traitements. Au cours de sa dernière année de vie, il a pris un remède empirique traditionnel, illégal, dans l'espoir de soulager le psoriasis. Cependant, 6 mois après la consommation du remède, de nombreuses papules sont apparues sur la jambe droite, et ont fini par former une grosse tumeur au cours des mois suivants. Le patient est mort d'une embolie pulmonaire aiguë, une semaine seulement après son hospitalisation, lorsque l'examen histopathologique de la tumeur a révélé qu'il s'agissait d'un carcinome verruqueux. Le remède a été analysé plus tard, et il s'est avéré que celui-ci contenait de l'arsenic. Le lien de cause à effet entre la tumeur et la consommation quotidienne d'arsenic fera l'objet de discussion.