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WELCOME

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WELCOME

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  1. WELCOME

  2. Management of Arsenicosis Dr.Md.Shahidullah Sikder Haider Jahan Dr.Hasibur Rahman

  3. Bangladesh

  4. Introduction: • Arsenic contamination of under groundwater has raised much concern due to its high potential to cause adverse health effects ranging from skin lesions to cancers of various organs. • There is no specific treatment available for Arsenicosis but there are some measures available for symptomatic management. • It is very essential to find out an appropriate treatment regimen of Arsenicosis.

  5. Subjects & Methods: • 750 patients selected randomly having suspected skin lesions of Arsenicosis during the period of January 1996 to July 2005 at dermatology department of Banghabhandhu Sheikh Mujib Medical University (BSMMU),Dhaka, Bangladesh. • Thorough clinical examination and relevant laboratory investigations were done. • Different modalities of treatment were applied among the different group of arsenicosis patients in different periods. • Along with avoidance of drinking arsenic contaminated water different regimen of treatment have been applied like : (i) Topical use of salicylic acid (5% to 30%). (ii) Systemic oral use of vitamin ACE, (iii) Oral use of spirulina with other nutritional supplement (iv) Cryotherapy for hyper keratosis, (v) Combination of topical application of salicylic acid with oral vitamin & other nutritional supplement. • The out come of the investigations & treatment was recorded properly.

  6. Rain drop Pigmentation with arsenical punctate keratosis

  7. Malnutrition with diffuse hyperpigmentation in chronic arsenicosis patient

  8. Warty Hyperkeratosis in the palm

  9. Warty Hyperkeratosis & Pigmentation on the Palm & Sole

  10. Unilateral leg oedema in chronic arsenicosis patient

  11. Chronic liver disease in chronic arsenicosis patient

  12. Bowen’s disease in chronic arsenicosis patientin the sole

  13. Cutaneous malignancy in chronic arsenicosis patient

  14. Result:

  15. Table # 01Dermatological Manifestation:

  16. Table # 02Systemic Manifestation:

  17. Table # 03Results of topical use of Salicylic acid:

  18. Table# 04Result of oral use of Vitamin AEC( Anti-oxidant Vitamin) on the following Manifestations:

  19. Table # 05Result of using spirulina & Nutritional Supplement:

  20. Table # 06Result of application of Cryotherapy for Hyperkeratosis:

  21. Table # 07Use of Combination therapy of Topical Salicylic acid with oral Vitamin & other nutritional supplement:

  22. Discussion & Conclusion: • Management of arsenicosis is a complicated issue which needs options of safe drinking water, appropriate topical & systemic medication. • No single medication is available to treat a fully developed arsenicosis patient satisfactorily. • In spite of avoidance of arsenic contaminated water & treatment with available medications some patients are detoriating. • Early diagnosis of arsenicosis & combination therapy may save many of the victim.

  23. Thank You