History:

This man was exposed to large amounts of arsenic in a medical treatment for asthma 40 years ago.He has developed multiple superficial squamous cell skin cancers mainly in sun exposed areas.Occassionally he has had an invasive Scc removed .He also had multiple palmar keratoses.The lag times for developing these lesions after arsenic exposure are 28 years for keratoses,39 years for Bowen's diseases and 41 years for invasive Scc in one series.Macular hyperpigmentation is also commonly found.