Document Detail

Pathogenesis, clinical features and pathology of chronic arsenicosis.
MedLine Citation:
PMID:  19171978     Owner:  NLM     Status:  MEDLINE    
Arsenicosis is a multisystem disorder, with virtually no system spared from its vicious claw; though its predominant manifestations are linked to cutaneous involvement. Cutaneous effects take the form of pigmentary changes, hyperkeratosis, and skin cancers (Bowen's disease, squamous cell carcinoma, and basal cell epithelioma). Peripheral vascular disease (blackfoot disease), hypertension, ischemic heart disease, noncirrhotic portal hypertension, hepatomegaly, peripheral neuropathy, respiratory and renal involvement, bad obstetrical outcome, hematological disturbances, and diabetes mellitus are among the other clinical features linked to arsenic toxicity. The effects are mediated principally by the trivalent form of arsenic (arsenite), which by its ability to bind with sulfhydryl groups present in various essential compounds leads to inactivation and derangement of body function. Though the toxicities are mostly linked to the trivalent state, arsenic is consumed mainly in its pentavalent form (arsenate), and reduction of arsenate to arsenite is mediated through glutathione. Body attempts to detoxify the agent via repeated oxidative methylation and reduction reaction, leading to the generation of methylated metabolites, which are excreted in the urine. Understandably the detoxification/bio-inactivation process is not a complete defense against the vicious metalloid, and it can cause chromosomal aberration, impairment of DNA repair process, alteration in the activity of tumor suppressor gene, etc., leading to genotoxicity and carcinogenicity. Arsenic causes apoptosis via free radical generation, and the cutaneous toxicity is linked to its effect on various cytokines (e.g., IL-8, TGF-beta, TNF-alpha, GM-CSF), growth factors, and transcription factors. Increased expression of cytokeratins, keratin-16 (marker for hyperproliferation) and keratin-8 and -18 (marker for less differentiated epithelial cells), can be related to the histopathological findings of hyperkeratosis and dysplastic cells in the arsenicosis skin lesion.
Sujit Ranjan Sengupta; Nilay Kanti Das; Pijush Kanti Datta
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Indian journal of dermatology, venereology and leprology     Volume:  74     ISSN:  0973-3922     ISO Abbreviation:  Indian J Dermatol Venereol Leprol     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2009-01-27     Completed Date:  2009-11-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7701852     Medline TA:  Indian J Dermatol Venereol Leprol     Country:  India    
Other Details:
Languages:  eng     Pagination:  559-70     Citation Subset:  IM    
Department of Dermatology, Medical College, Kolkata, India.
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MeSH Terms
Arsenic / adverse effects
Arsenic Poisoning / epidemiology*,  etiology,  pathology*
Chronic Disease
Environmental Exposure / adverse effects
Skin Diseases / epidemiology*,  etiology,  pathology*
Water Pollutants / adverse effects
World Health Organization
Reg. No./Substance:
0/Water Pollutants; 7440-38-2/Arsenic

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