This patient shows multiple skin lesions associated with arsenic, including hyperkeratosis, suspected Bowen disease, and non-healing ulcers (suspected cancer).
Reproduced with permission from Chakroborti, D, Mukherjee, SC, Pati, S, et al. Arsenic groundwater contamination in Middle Ganga Plain, Bihar, India: a future danger? Environ Health Perspect 2003; 111:1194.