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Various forms of arsenic-containing medicine are still being used in many parts of the world, including Thailand.¹ Patients with chronic arsenic toxic effects may have internal cancers and many cutaneous lesions such as those associated with Bowen disease (BD), arsenical keratoses (ArKs), squamous cell carcinomas (SCCs), and basal cell carcinomas (BCCs).¹ These patients generally have multiple recurrent skin cancers and precancerous lesions.

Recently, imiquimod, a novel topical immune response modifier, has been demonstrated to be safe and effective in the treatment of actinic keratosis,² BD, SCC,³ and BCC.^4-5 To my knowledge, imiquimod has not been reported in the treatment of ArK.

Report of a Case

A 73-year-old Thai man presented with 2 biopsy-proven ArKs on his left forearm (Figure) and knee, respectively, a BCC at the lower abdomen, and 2 BD lesions at the left thigh and right nipple, respectively. He had generalized raindrop hypo-hyperpigmentation and punctate palmoplantar keratosis but was otherwise . . . [Full Text of this Article]

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AUTHOR INFORMATION
Waranya Boonchai, MD, MMedSc