Prevalence of Skin Cancer in Chronic Arsenicosis in Chittagong Medical College Hospital, Bangladesh

Abstract

A descriptive study was done in the Department of Dermatology and Venereology; Chittagong Medical College Hospital, Chittagong, during the period of July 2004 to June 2008, to find out the prevalence of skin cancer among various skin manifestations of chronic arsenicosis. All suspected patients of chronic arsenicosis coming from endemic zones of Bangladesh were the study population. A total number of 234 patients of chronic arsenicosis were included in this study. The patients were diagnosed by physical examination and by estimation of arsenic level of scalp hair. The majority of the patients came from Noakhali, Chitagong, Feni, Laxmipur, Comilla and Chandpur districts. The mean age of the patients was 27.80 years ± 10.22 SD (Range: 12-70 years). About 70% patients were around 30 years of age. The male & female ratio was 1.9: 1. Most of them came from average socio-economic status. About 28.6 % patients were students, while about 25% patients were daily labour. 94 % patients used tube well as drinking water source. 12.8o patients had family history of chronic arsenicosis and about 19% patients took alternative medicines (homeopathic /kobirajee) for treatment of the same or other illness. The cent percent patients presented with hypo and hipermelanosis (rain drop pigmentation), while 90,6 % patients were with hyperkeratosis in palms and soles. The measurement of arsenic in scalp hair was done. The mean arsenic level of scalp hair was found to be 2.63 1.39 SD (range: 2.0 - 17.6 mg/kg). Skin biopsy for histopathology was done for suspected patients and skin lesions of 21.4% patients were detected as arsenical keratosis. Among the total patients, 6 (six) patients were found to develop skin cancers (2.6 %). Among them, 3 patients developed Squamous Cell Carcinoma (SCC), 1 patient developed Basal Cell Carcinoma (BCC), while Bowen's disease and Melanoma was found in I patient each. Regarding treatment response, about 48% patients showed good response with topical ........