Acta Derm Venereol. 2000 Jul-Aug; 80(4): 292-3.

Papular palmoplantar hyperkeratosis following chronic medical exposure to arsenic: human papillomavirus as a co-factor in the pathogenesis of arsenical keratosis?

Gerdsen R, Stockfleth E, Uerlich M, Fartasch M, Steen KH, Bieber T.

Department of Dermatology, University of Bonn, Germany.

This study presents the case of a 38-year-old patient from Pakistan with vitiligo, who developed multiple verrucous papules on the palms and soles several years after receiving "herbal treatment" from a travelling Indian doctor for a period of 12 months. Histopathological examination showed changes consistent with the diagnosis of arsenical keratosis. Molecularbiological examination of a skin biopsy detected an atypical human papillomavirus. This observation supports the concept of human papillomavirus as a co-factor in the pathogenesis of premalignant arsenic-induced skin tumours.