An Interesting Case of Basal Cell Carcinoma with Raynaud’s Phenomenon Following Chronic Arsenic Exposure

Abstract

Arsenic is commonly known to be associated with squamous cell carcinoma. Among the lesser known associations is basal cell carcinoma and even rarer is its effect on blood vessels causing peripheral vascular disease. Here we present a case of a 55 yr old man with ulceroproliferative lesions on scalp and forehead along with several hyperpigmented patches on trunk and extremities. He had symptoms suggestive of Raynaud’s phenomenon that eventually led to digital gangrene. FNAC was done which was suggestive of basal cell carcinoma. On further enquiry, he was found to reside in an arsenic endemic zone and was investigated for blood arsenic level which was elevated. Punch biopsy from different lesions from body confirmed nodular basal cell carcinoma. Presently the patient has stopped drinking water from the local tubewell. On follow-up he shows improvement of Raynaud’s phenomenon and skin lesions.Keywords: basal cell carcinoma; chronic arsenic exposure; raynaud’s phenomenon. | PubMed

Cutaneous manifestations and treatment of arsenic toxicity: A systematic review

“…Multiple studies have demonstrated that eliminating arsenic exposure is strongly associated with preventing further cutaneous manifestations 5,41–47 . Although both Tay et al.…”

“…Multiple studies have demonstrated that eliminating arsenic exposure is strongly associated with preventing further cutaneous manifestations. 5,[41][42][43][44][45][46][47] Although both Tay et al and Wagner et al's findings suggested dimercaprol may only be effective in acute and subacute arsenic toxicity, other chelation therapy may improve some dermatological presentations in the chronic phase. 15,16 A case report and case series demonstrated a positive association between individuals taking oral Dpenicillamine with improvement of cutaneous presentations such as palmoplantar hyperkeratosis that were suspected to be chronic arsenic-induced.…”

Cross-Talk between Wnt and Hh Signaling Pathways in the Pathology of Basal Cell Carcinoma

“…Immunocompromised patients have also been reported to have a higher risk of developing BCC than the general population [ 9 , 10 ] and BCCs appear to show a more aggressive behavior in these patients [ 11 ]. Chronic exposure to arsenic might also be responsible for the incidence of BCC development [ 12 , 13 , 14 ]. BCCs can be generally classified in four groups according to the form of growth pattern.…”