An Outbreak of Arsenical Dermatoses in a Mining Community

Abstract

Arsenic trioxide, or white arsenic, an ancient and oft-used poison, produced by the smelting of arsenic-containing nonferrous ores. Although exposure of smelter workers to arsenic is frequently high enough to produce contact skin diseases, irritation of the mucous membranes of the respiratory tract, and elevated levels of arsenic in the urine, manifestations of systemic intoxication are surprisingly rare. In an outbreak of contact arsenical skin disease observed recently at a metal smelter, family members in the adjoining mining community were also affected. A variety of skin and mucous membrane lesions were observed: eczematous contact dermatitis, folliculitis, pyoderma, ulcerations, and conjunctivities and rhinitis. The eczematous dermatitis was pruritic and usually involved the face and flexures. Perforation of the nasal septum was observed only in roaster operators. On the basis of a patch test study with arsenic trioxide (5% in starch), it is believed that allergy was not an important factor in the onset or recurrence of the arsenical contact dermatoses.