- Sources of exposure: metal smelting, pesticides, herbicides
- Pathophysiology
- Has direct toxic effects on endothelial cells
- Induces oxidative stress, and disrupts ATP production
- Clinical features
- Acute toxicity
- Nausea and vomiting
- Abdominal pain, diarrhea
- Tachycardia, QT prolongation
- Garlic-like odor on the breath
- CNS (coma, seizures)
- Chronic toxicity
- Carcinogenic
- Arsenical keratosis: hyperkeratosis (especially on the soles and palms) → risk of developing squamous cell carcinoma)
- White bands across the nails (Mees lines)
- Treatment
- Consider gastric lavage, activated carbon in acute toxicity
- Dimercaprol, succimer (in children)
- Chelating agents used to treat metal toxicity