Ecotoxicol Environ Saf 2017 Oct 15;144:227-235. Epub 2017 Jun 15.

Department of Agricultural Chemistry and Soil Science, Bidhan Chandra Krishi Viswavidyalaya, Mohanpur, Nadia, West Bengal 741 252, India.

Safe limit of arsenic in soil in relation to dietary exposure of arsenicosis patients was established in Malda district of West Bengal. Out of 182 participants examined, 80 (43.9%) participants showed clinical features of arsenicosis, characterized by arsenical skin lesion (pigmentation and keratosis), while 102 participants did not have any such lesion (control). Read More

Australas J Dermatol 2016 May 24;57(2):e66-8. Epub 2015 Aug 24.

Division of Dermatology, Florida State University College of Medicine, Tallahassee, Florida, USA.

Agent Blue was an arsenical herbicide used extensively in the Vietnam War. Arsenic is one of the known causes of acquired palmoplantar keratoderma (PPK). The most common manifestation of arsenic exposure in susceptible individuals is bilateral palmoplantar hyperkeratosis. Read More

J Cutan Med Surg 2016 Jan 3;20(1):67-71. Epub 2015 Aug 3.

Faculty of Medicine, Memorial University of Newfoundland, NL, 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. Read More

Int J Dermatol 2016 Mar 31;55(3):289-95. Epub 2015 Jul 31.

Division of Arsenic Research, Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Background: Chronic arsenic exposure can lead to palmoplantar keratosis. In the stratum corneum of skin, linoleic acid is of the utmost importance to the inflammation, keratinization, and regeneration processes.

Objectives: The aims of this study were: (i) to present quantitative information on the linoleic acid fraction of intercorneocyte lipids, and (ii) to elucidate the role of linoleic acid in the pathophysiology of arsenical keratosis. Read More

Int J Clin Exp Med 2015 15;8(1):1487-90. Epub 2015 Jan 15.

Department of Dermatology, The First Affiliated Hospital of Anhui Medical University Hefei 230022, P. R. China.

Medication-induced arsenical keratosis is a rare type of arsenical keratosis. We describe here a case of 70-year-old man to explore the clinical characters, diagnosis and treatment of medication-induced arsenical keratosis in order to improve the understanding of this disease and reduce the misdiagnosis rate. The clinical characters, signs, lab findings as well as progression, diagnosis and treatment in the case of arsenical keratosis were analyzed. Read More

Ugeskr Laeger 2014 May;176(19)

Plastikkirurgisk Afdeling Z, Plastikkirurgisk Forskningsenhed, Aarhus Universitetshospital, Nørrebrogade 44, 8000 Aarhus C.

Cutaneous malignancy in association with arsenic exposure is a rare but well-documented phenomenon. Signs of chronic arsenic exposure are very rare in Denmark today. However, arsenic was used in the medical treatment of psoriasis vulgaris up till the 1980's and several patients suffer from this arsenic treatment today. Read More

Actas Dermosifiliogr 2013 Oct 20;104(8):672-8. Epub 2013 Aug 20.

Centro Dermatológico Federico Lleras Acosta, E.S.E, Bogotá D.C., Colombia. Electronic address:

Introduction: Nonmelanoma skin cancer is the most common malignancy in white individuals. The risk factors for squamous cell carcinoma, which belongs to the family of nonmelanoma skin cancers, have not been studied in Colombia.

Objective: To determine the risk factors for squamous cell carcinoma in patients at a national referral center for skin diseases in Colombia. Read More

Internist (Berl) 2013 Jun;54(6):671-82

Klinik für Dermatologie, Venerologie und Allergologie, Hauttumorcentrum, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

Precancerous skin lesions and carcinomas in situ of the skin represent the early stages of epithelial skin tumors. There is no invasive tumor growth, so the basement membrane is completely intact. These lesions show a wide variation of clinical and histological appearances on the skin or mucosa. Read More

Am J Epidemiol 2013 Feb 7;177(3):213-6. Epub 2013 Jan 7.

Center for Cancer Epidemiology and Prevention, University of Chicago Medical Center, Chicago, IL 60615, USA.

Arsenic exposure affects millions of people worldwide, causing substantial mortality and morbidity from cancers and cardiovascular and respiratory diseases. An article in the current issue (Am J Epidemiol. 2013;177(3):202-212) reports that classic dermatological manifestations, typically associated with chronic arsenic exposure, are predictive of internal cancers among Taiwanese decades after the cessation of exposure. Read More

Environ Geochem Health 2012 Oct 12;34(5):563-74. Epub 2012 May 12.

Department of Earth Sciences, National Cheng Kung University, Tainan, 70101, Taiwan.

Drinking of arsenic (As)-contaminated groundwater has adverse effects on health of millions of people worldwide. This study aimed to determine the degree of severity of As exposure from drinking water in peri-urban Moyna and Ardebok villages, West Bengal, India. Arsenic concentrations in hair, nail and urine samp les of the individuals were determined. Read More

Clin Toxicol (Phila) 2011 Jun 17;49(5):374-8. Epub 2011 May 17.

Division of Arsenic Research, Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University, Shahba, Dhaka, Bangladesh.

Background: Melanosis and leucomelanosis with or without keratosis are the earliest symptoms of arsenicosis. Uneven distribution of arsenical melanosis and leucomelanosis in skin led us to investigate the possibility of preferential secretion of arsenic and three constituents of sweat; cholesterol, vitamin E, and zinc.

Methods: Twenty-four-hour skin secretion was collected from skin lesions and unaffected sites of 20 patients. Read More

J Assoc Physicians India 2010 Oct;58:617-24, 629

Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012.

Human health in the past and presently is influenced by the amounts and proportion of chemical elements to which humans have been exposed. Arsenic, as a therapeutic agent was known to ancient Greeks and Romans. Ehrlick introduced organic arsenicals as anti linetic agents but with advent of penicillin these have nearly become obsolete. Read More

Am J Epidemiol 2011 Apr 4;173(7):778-86. Epub 2011 Mar 4.

Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.

Inorganic arsenic is metabolized to monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). Limited evidence suggests that the ability to fully metabolize arsenic into DMA influences susceptibility to disease. To determine whether percentage of MMA was predictive of disease, the authors used data from a case-control study conducted in Bangladesh (2001-2003). Read More

Dermatol Clin 2011 Jan;29(1):45-51

Department of Medicine, University of Chicago Medical Center, IL 60637, USA.

Arsenic is considered a Class I human carcinogen by the International Agency for Research on Cancer because of its increased risk for skin cancer, as well as internal cancers, such as lung and bladder cancer. Arsenic contamination of drinking water in Bangladesh has been called the "largest mass poisoning of a population in history." This inorganic arsenic contamination is of natural origin, with arsenic thought to be released to the groundwater from the surrounding sediment. Read More

J Am Acad Dermatol 2012 Jul 3;67(1):e49-55. Epub 2010 Nov 3.

Department of Dermatology, Royal Perth Hospital, Perth, Australia.

Background: Multiple minute digitate hyperkeratosis (MMDH) is a rare disorder of keratinization with many different names.

Objective: We present a case of MMDH and review the literature. We propose and discuss the classification the digitate keratoses, which include MMDH, lichen spinulosus, phrynoderma, spiny keratoderma, arsenical keratosis, multiple filiform verrucae, postirradiation digitate keratosis, trichodysplasia spinulosa, and hyperkeratotic spicules. Read More

Cutis 2010 Apr;85(4):199-202

Department of Dermatology, University of Virginia Health System, Charlottesville, USA.

Long-term exposure to arsenic has been linked to the development of numerous cutaneous neoplasms including arsenical keratoses, basal cell carcinomas (BCCs), and squamous cell carcinomas (SCCs). We report a patient with a remote history of psoriasis treated with arsenic who subsequently developed more than 40 nonmelanoma skin cancers as well as arsenical keratoses. This patient had a remarkable response to imiquimod cream 5% applied once daily to affected areas for 6 weeks with complete resolution of all cutaneous neoplasms and no evidence of recurrence in more than 3 years of clinical surveillance. Read More

N Z Med J 2010 Feb 19;123(1309):111-3. Epub 2010 Feb 19.

Department of Medicine, Nil Ratan Sircar Medical College and Hospital, Kolkata, India.

Sci Total Environ 2010 Mar 22;408(7):1523-9. Epub 2010 Jan 22.

Department of Medical Physics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

First, we determined the levels of 8 trace elements (As, Se, Hg, Cd, Ag, Mn, Cr and Pb) in 530 village drinking water sources by graphite furnace or flame atomic absorption spectroscopy method, in Kurdistan Province in the west of Iran. The results showed that the level of As, Cd and Se in 28 village drinking water sources exceeded WHO or National Standard limits. The levels of concentration of arsenic in drinking water ranged from 42 to 1500microg/L. Read More

Indian J Med Res 2009 Jan;129(1):75-82

Department of Community Medicine, Calcutta National Medical College, Kolkata, India.

Background & Objective: Pigmentation and keratosis are the prerequisites to diagnose arsenicosis. However, many systemic manifestations occur in association with pigmentation and keratosis in people exposed to chronic drinking of arsenic contaminated water. The present study aim to find out whether systemic manifestations occur in significant number of cases in arsenic exposed people in the absence of skin lesions in an affected district in West Bengal, India. Read More

Dermatol Online J 2008 Oct 15;14(10):24. Epub 2008 Oct 15.

Department of Dermatology, New York University, USA.

A 42-year-old man presented with a six-month history of a slowly-enlarging ulcer on his right sole, a 30-year history of altered pigmentation of the trunk and extremities, and hyperkeratotic papules of the palms and soles. Histopathologic examination showed an invasive squamous-cell carcinoma of the right sole and hyperkeratosis with keratinocyte atypia of the left finger and left lateral foot. The clinical and histopathologic findings are consistent with chronic arsenicism, which most commonly occurs in the setting of drinking contaminated water or after occupational exposure. Read More

Int J Dermatol 2008 Jun;47(6):618-21

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Background: Ayurvedic medicines are known to contain arsenic and concentrations up to toxic levels have been reported in certain formulations. However, clinical disease due to arsenic containing ayurvedic medicines has rarely been reported. We seek to highlight the existence of toxic levels of arsenic in certain ayurvedic preparations that can produce serious systemic manifestations. Read More

Int J Dermatol 2008 Jun;47(6):592-3

Department of Dermatological Sciences, University of Florence, Florence, Italy.

Clin Exp Dermatol 2008 Mar 24;33(2):202-4. Epub 2007 Nov 24.

Rev Med Liege 2007 Feb;62(2):94-6

Service de Dermatologie, Centre Hospitalier Universitaire de Liège, Belgique.

Arsenic is an ubiquitary element which has been widely used for centuries in different fields such as medicine, agriculture or industry. Acute or chronic exposure to As can lead to various dermatological and systemic disorders with a possibe latency over decades. The dermatological signs of As intoxication are important to detect since one of the potential complications is carcinoma. Read More

Am J Dermatopathol 2006 Dec;28(6):537-45

Ackerman Academy of Dermatopathology, 145 E 32 St, Fl 10, New York, NY 10016, USA.

Squamous-cell carcinoma is the most common of all cancers and it develops in diverse organs of the body, among those being the skin, lung, gastrointestinal tract, and genitourinary tract, the latter including the cervix. Unfortunately, no unanimity exists for naming very superficial squamous-cell carcinoma; it has not been designated in consistent fashion in a single organ, let alone in all of them, thereby resulting in confusion, not only in regard to terminology per se, but concerning matters conceptual, not the least of those being what appellation to apply to that condition when it is encountered histopathologically. This vexing situation is illustrated graphically in the skin by diagnoses for very superficial squamous-cell carcinoma as disparate as solar keratosis (actinic keratosis, senile keratosis), arsenical keratosis, radiation keratosis, Bowen disease, bowenoid papulosis, squamous-cell carcinoma in situ, as well as variations on the theme of "keratinocytic intraepidermal neoplasia" and "dysplasia," and in the cervix by squamous-cell carcinoma in situ, leukoplakia, cervical intraepithelial neoplasia I-III, as well as variations on the theme of "squamous dysplasia (). Read More

J Environ Sci Health A Tox Hazard Subst Environ Eng 2006 ;41(10):2399-428

The Safe Drinking Water Foundation, Saskatoon, Saskatchewan, Canada.

The ill effects of human exposure to arsenic (As) have recently been reevaluated by government agencies around the world. This has lead to a lowering of As guidelines in drinking water, with Canada decreasing the maximum allowable level from 50 to 25 microg/L and the U.S. Read More

Sci Total Environ 2006 Nov 8;370(2-3):310-22. Epub 2006 Aug 8.

School of Environmental Studies, Jadavpur University, Kolkata 700032, India.

This communication presents results of our 2-year survey on groundwater arsenic contamination in three districts Ballia, Varanasi and Gazipur of Uttar Pradesh (UP) in the upper and middle Ganga plain, India. Analyses of 4,780 tubewell water samples revealed that arsenic concentrations in 46.5% exceeded 10 microg/L, in 26. Read More

Int J Environ Res Public Health 2004 Sep;1(2):83-9

Molecular Toxicology Research Laboratory, NIH-Center for Environmental Health, Jackson State University, Jackson, MS 39217, USA.

Arsenical keratosis and skin cancer are among the most common health effects associated with acute and chronic exposures to arsenic. This study examines the acute and chronic dose-responses of arsenic in established human cell lines using keratinocytes (HaCaT), melanocytes (CRL1675) and dendritic cells (THP-1 + A23187). Chronic conditions were established by treating the three cell lines with at least 8 passages in 0. Read More

Clin Toxicol (Phila) 2005 ;43(7):835-48

Department of Neurology, Medical College and Hospital, Kolkata, India.

Introduction: To understand the severity of related health effects of chronic arsenic exposure in West Bengal, a detailed 3-year study was carried out in Murshidabad, one of the nine arsenic-affected districts in West Bengal.

Methods: We screened 25,274 people from 139 arsenic-affected villages in Murshidabad to identify patients suffering from chronic arsenic toxicity for evidence of multisystemic features and collected biological samples such as head hair, nail, and spot urine from the patients along with the tubewell water they were consuming.

Results: Out of 25,274 people screened, 4813 (19%) were registered with arsenical skin lesions. Read More

J Cutan Pathol 2006 Feb;33(2):129-38

Department of Dermatology, Kaohsiung Medical University, Kaohsiung, Taiwan.

Background: beta1-integrins, which localize to the basolateral surface of basal keratinocytes, are important in the differentiation control and proliferation of the epidermis. Many cutaneous diseases with perturbed differentiation, including arsenical keratosis, show altered patterns of integrin distribution and expression. Arsenic may induce arsenical keratosis through the differentiation and apoptosis aberration by integrins. Read More

Toxicol Lett 2006 Jun 10;163(3):191-7. Epub 2006 Jan 10.

Institute of Molecular and Cellular Biology, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei 106, Taiwan.

Inorganic arsenic has strong human carcinogenic potential, but the availability of an animal model to study toxicity is extremely limited. Here, we used the transgenic zebrafish line Tg(k18(2.9):RFP) as an animal model to study arsenite toxicity. Read More

Rev Med Liege 2005 Apr;60(4):217-21

CHR hutois, Service de Dermatologie, Huy.

We report the case of a 70-year old man who presented the classical cutaneous signs of chronic arsenicism : palmo-plantar keratoses and lesions of Bowen's disease. Within a few months, the patient developed multiple large superficial basal cell carcinomas on the trunk and several invasive squamous cell carcinomas. A pulmonary cancer with cerebral metastases was also identified. Read More

J Environ Pathol Toxicol Oncol 2005 ;24(1):45-56

Environmental Carcinogenesis and Toxicology, Chittaranjan National Cancer Institute, Kolkata, India.

The Gangetic plain of West Bengal, India, has been engulfed by a disastrous environmental calamity of arsenic contamination of the ground water. Chronic arsenic toxicity caused by drinking arsenic-contaminated water has been one of the worst health hazards gradually affecting nine districts of West Bengal since the early 1980s. Over and above hyperpigmentation and keratosis,weakness, burning sensation of the eyes, swelling of the legs, liver fibrosis, chronic lung disease, gangrene of the toes, neuropathy, and skin cancer are other manifestations. Read More

Indian J Public Health 2004 Jan-Mar;48(1):30-3

Department of Community Medicine, N. R. S. Medical College, Kolkata.

The spatial distribution of chronic arsenicosis due to consumption of arsenic contaminated tube well water in different districts of West Bengal was gradually unfolding since 1983. Arsenical dermatosis was found to be the commonest and earliest manifestation of chronic arsenic toxicity. This study was conduct in Baruipur block of South 24 Parganas district of West Bengal. Read More

Environ Geochem Health 2005 Feb;27(1):47-53

Department of Family and Community Medicine, UNM School of Medicine, Albuquerque, New Mexico 87131,USA.

Populations living in the Southwest United States are more likely to be exposed to elevated drinking water arsenic levels compared to other areas of the country. Skin changes, including hyperpigmentation and generalized hyperkeratosis, are the most common signs of chronic arsenic ingestion from drinking water. The purpose of this study was to determine the feasibility of using dermatology practices in New Mexico, Arizona, and western Texas as a surveillance system for arsenical skin disorders related to drinking water. Read More

J Toxicol Clin Toxicol 2003 ;41(7):963-7

School of Environmental Studies, Jadavpur University, Kolkata, India.

Unlabelled: Homeopathic medicine is commonly believed to be relatively harmless. However, treatment with improperly used homeopathic preparations may be dangerous.

Case Reports: Case 1 presented with melanosis and keratosis following short-term use of Arsenic Bromide 1-X followed by long-term use of other arsenic-containing homeopathic preparations. Read More

J Dermatol 2003 Oct;30(10):730-4

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

A case of arsenical keratosis with multiple lesions of Bowen's disease and squamous cell carcinoma is described. The patient was successfully treated with a combination of acitretin and intralesional 5-fluorouracil. All the lesions resolved after three months of therapy with no side effects and no recurrence during four months of follow-up. Read More

Chemosphere 2003 Sep;52(9):1353-9

National Research Centre for Environmental Toxicology, The University of Queensland, 39 Kessels Road, Coopers Plains, Brisbane, Queensland 4108, Australia.

Arsenic is a carcinogen to both humans and animals. Arsenicals have been associated with cancers of the skin, lung, and bladder. Clinical manifestations of chronic arsenic poisoning include non-cancer end point of hyper- and hypo-pigmentation, keratosis, hypertension, cardiovascular diseases and diabetes. Read More

J Environ Sci Health A Tox Hazard Subst Environ Eng 2003 Jan;38(1):255-72

School of Environmental Studies, Jadavpur University, Kolkata, India.

Arsenicosis is chronic subclinical or clinical toxicity due to high level of arsenic in body. Diagnosis of arsenicosis was derived by chronological establishment of facts: (a) arsenic as the cause of malady, (b) drinking water (tubewell water) as the vehicle of arsenic, (c) soil as the source of arsenic, (d) mechanism of leaching of arsenic from soil, and (e) cause of prevalence in particular areas of the country. Arsenicosis has been classified by the author into 4 stages, 7 grades and 20 subgrades. Read More

Environ Health Perspect 2002 Oct;110 Suppl 5:883-6

Division of Biophysical Toxicology, U.S. Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.

Millions now suffer the effects of chronic arseniasis related to environmental arsenic exposure. The biological mechanisms responsible for arsenic-induced toxicity and especially chronic effects, including cancer, are not well known. The U. Read More

Int J Dermatol 2002 Feb;41(2):84-7

Department of Dermatology, Akdeniz University School of Medicine, Antalya, Turkey.

Background: Long-term exposure to arsenic is associated with the development of arsenical keratosis, Bowen's disease, squamous cell carcinoma, and basal cell carcinoma. The efficacy of acitretin therapy was examined in two patients with cutaneous arsenical neoplasms.

Methods: Lipid profile, hematological and liver function tests were performed regularly during the therapy at monthly intervals. Read More

Clin Geriatr Med 2002 Feb;18(1):1-19, v

Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut06520, USA.

This article concentrates on the major signs and syndromes that are associated with internal malignancies in the geriatric population. Included are cutaneous metastases, ectopic adrenocorticotropic hormone-producing syndromes, and disorders arising from APUD cell tumors. The major paraneoplastic disorders of dermatomyositis, generalized pruritus, Bazex's syndrome, and acanthosis nigricans also are discussed. Read More

J Toxicol Clin Toxicol 2001 ;39(7):683-700

School of Environmental Studies, Jadavpur University, Kolkata, India.

Fifty districts of Bangladesh and 9 districts in West Bengal, India have arsenic levels in groundwater above the World Health Organization's maximum permissible limit of 50 microg/L. The area and population of 50 districts of Bangladesh and 9 districts in West Bengal are 118,849 km2 and 104.9 million and 38,865 km2 and 42. Read More

J Dermatol 2001 Nov;28(11):628-31

Department of Dermatology, Kaohsiung Medical University, Taiwan.

This presentation focuses on the four most important skin diseases in Taiwan thought to be of environmental and/or occupational origin. The majority of work-related dermatoses are contact dermatitis patients. Among occupational contact dermatitis patients, 58. Read More

Acta Derm Venereol 2000 Jul-Aug;80(4):292-3

Department of Dermatology, University of Bonn, Germany.

This study presents the case of a 38-year-old patient from Pakistan with vitiligo, who developed multiple verrucous papules on the palms and soles several years after receiving "herbal treatment" from a travelling Indian doctor for a period of 12 months. Histopathological examination showed changes consistent with the diagnosis of arsenical keratosis. Molecularbiological examination of a skin biopsy detected an atypical human papillomavirus. Read More

Occup Environ Med 1999 Apr;56(4):277-81

Department of Health and Environment, Faculty of Health Sciences, Linköping University, Sweden.

Objectives: Exposure to arsenic causes keratosis, hyperpigmentation, and hypopigmentation and seemingly also diabetes mellitus, at least in subjects with skin lesions. Here we evaluate the relations of arsenical skin lesions and glucosuria as a proxy for diabetes mellitus.

Methods: Through existing measurements of arsenic in drinking water in Bangladesh, wells with and without arsenic contamination were identified. Read More

Environ Health Perspect 1999 Aug;107(8):687-9

Department of Public Health, Ankara University Medical School, Ankara, Turkey.

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. Read More

Br J Dermatol 1998 Aug;139(2):291-4

Department of Dermatology, Osaka City University Medical School, 1-5-7 Asahimachi, Abeno-ku, Osaka 545, Japan.

We diagnosed a unique case of Merkel cell carcinoma (MCC) coexisting with Bowen's disease on the sole of the foot of a 72-year-old man who had worked for about 4 years in a factory handling inorganic arsenic. He had a past history of arsenical keratosis and multiple Bowen's disease. The tumour first appeared as a reddish macule and then showed marked growth over the next month. Read More

Lakartidningen 1998 Jun;95(26-27):3075-8

Yrkes- och miljömedicinska kliniken, Folkhälsovetenskapligt centrum, Linköping.

J Am Acad Dermatol 1996 Aug;35(2 Pt 1):223-42

Dermatology and Pathology, UMDNJ-New Jersey Medical School, Newark 07103-2714, USA.

Premalignant keratinocytic keratoses are common, especially in pale-complected persons in whom they appear most often as an actinic keratosis. Although the actinic keratosis has a very low malignant potential, arsenic, tar, thermal, scar, reactional, and radiation keratoses may be more clinically aggressive. This article discusses these premalignant keratinocytic neoplasms. Read More