Characteristics of Palmar Arsenical Keratosis Patients

Background: Arsenic contamination of groundwater is a persistent public health issue in many developing regions, especially in Bangladesh. Chronic exposure through contaminated drinking water has been associated with multiple health effects, including dermatological conditions such as palmar arsenical keratosis one of the most characteristic indicators of arsenicosis. Objective: This study aimed to evaluate the demographic, clinical, and exposure-related characteristics of patients diagnosed with palmar arsenical keratosis in a highly arsenic-endemic region of Bangladesh. Methodology: This observational study was conducted between September 2019 and January 2021 in the Chuadanga district, involving 32 patients diagnosed with moderate-to-severe palmar arsenical keratosis. Demographic data, exposure history, and lesion characteristics were collected. Arsenic levels in tube well water and fingernail samples were quantified using the silver diethyldithiocarbamate method. Ethical approval and informed consent were obtained prior to participation. Results: The mean age of the patients was 43.1 ± 11.5 years, with a male-to-female ratio of 5:3. The average duration of arsenic exposure was 20.5 ± 7.7 years, with symptoms appearing after approximately 11.1 ± 5.3 years. Arsenic concentrations in drinking water were significantly elevated (mean: 293.1 ± 114.8 µg/l), far exceeding WHO standards. Correspondingly, arsenic levels in fingernails averaged 11.4 ± 2.4 µg/g, confirming prolonged internal exposure. Conclusion: This study reaffirms that long-term arsenic exposure, particularly through contaminated tube well water, leads to clinically evident palmar keratosis. The high arsenic burden observed in both environmental and biological samples highlights the critical need for arsenic mitigation strategies, improved public awareness, and early detection efforts in endemic regions.