Arsenical keratoses with squamous cell carcinoma
A 60-year-old man, residing in Murshidabad, West Bengal, presented with multiple, painless, asymptomatic raised lesions over palms and soles of 4-years duration. On cutaneous examination, both palms showed multiple, hyperkeratotic papules. A solitary 2 × 2 cm ulcero-proliferative growth with sero-sanguineous discharge was seen over the thenar eminence of the right hand [Figure 1]. Histopathological examination of the ulcero-proliferative lesion was suggestive of moderately differentiated squamous cell carcinoma. Arsenic content as measured in hairs and nails was high (normal values: up to 0.61 mcg/gm for hairs and up to 0.23 mcg/gm for nails). He was diagnosed as a case of arsenical keratoses with squamous cell carcinoma and treated with surgery and chemotherapy.