

Answer to Medical Mystery Monday #71

A skin cancer caused by arsenic poisoning. From


Arsenic is a heavy metal that is toxic to humans. The most common causes of arsenic toxicity are occupational exposure, deliberate poisoning, or contamination of food or water. Note that for our patient, I hinted that her husband might be poisoning her since he is a chemist and would have access to arsenic. Arsenic inhibits cellular energy production and protective mechanisms against cellular damage. Chronic toxicity often causes dysfunction of the nerves, leading to pain, weakness, and numbness in the extremities. Arsenic also causes uncontrolled division of skin cells, producing characteristic growths on the soles and palms, and even leading to skin cancer in some instances. Poisoning with arsenic and other heavy metals can produce distinctive white marks on the fingernails. Gastrointestinal complaints and fatigue are also common.

The patient should be treated with a medication that will bind all the arsenic left in her system so it can be excreted. She will need a skin cancer screen, and likely surgical removal of the growths on her feet. In this fictitious case, the police might be called upon to investigate the husband as well!

If you have a suggestion for a future Medical Mystery, let me know – mdtobeblog (at) gmail (dot) com.

Marianne DiNapoli