Chronic arsenic poisoning over months to years produces a characteristic dermatological triad. Which description BEST captures this triad?
- A Mees' lines on fingernails + Rain-drop pigmentation (hyperpigmentation with areas of hypopigmentation) + Palmar-plantar keratosis ✓
- B Beau's lines + vitiligo-like depigmentation + alopecia
- C Leukonychia + photo-sensitive dermatitis + peripheral edema
- D Splinter hemorrhages + palmar erythema + spider angiomata
Explanation
Chronic arsenic poisoning (arsenicosis) presents with a classical dermatological triad: (1) Mees' lines — transverse white bands on fingernails due to arsenic depositing during periods of toxicity; (2) 'Rain-drop' or 'dew-drop' pigmentation — generalized macular hyperpigmentation (melanosis) interspersed with small hypopigmented macules giving a 'rain on dusty road' appearance; (3) Palmar-plantar keratosis — symmetrical hyperkeratotic papules and plaques on palms and soles. This triad is pathognomonic of chronic arsenicosis (commonly from contaminated groundwater) and precedes development of Bowen's disease and squamous cell carcinoma. Beau's lines (B) are transverse grooves indicating acute illness; splinter hemorrhages (D) suggest infective endocarditis.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.