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September 1996

Numerous Erythematous Truncal Plaques

Author Affiliations

Hospital of the University of Pennsylvania, Philadelphia

Arch Dermatol. 1996;132(9):1107-1108. doi:10.1001/archderm.1996.03890330121022

REPORT OF A CASE  A 69-year-old male pharmacist was diagnosed as having cutaneous T-cell lymphoma at the age of 44 years. Reportedly, he was treated at the time with 2 pints of Fowler solution (pentavalent arsenic), which was administered orally. His cutaneous T-cell lymphoma eventually cleared with aqueous nitrogen mustard treatment, but he continued to use a "general tonic" periodically. At the age of 55 years, numerous erythematous plaques, ranging from 3 to 15 cm in diameter, began to develop on his chest, back, extremities, and scalp (Figure 1 and Figure 2). His palms and soles were spared. Several of the truncal lesions were pigmented and had surrounding telangiectasias. Biopsy specimens were obtained, and representative sections are shown in Figure 3 and Figure 4.What is your diagnosis?

DIAGNOSIS:  Multiple basal cell carcinomas associated with arsenic ingestion.

DISCUSSION  The association of arsenic ingestion and basal cell carcinoma

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