Asian Pacifc Journal of Health Sciences | Vol. 5 | Issue 1 | January-March | 2018 Page | 182 poisoning presents with severe abdominal pain, burning of the lips and mouth, projectile vomiting and severe blood stained diarrhea, restlessness, thirst, severe muscle cramp, oliguria and proteinuria leading to collapse, shock, and death. Acute arsenic poisoning usually occurs as suicidal, homicidal, and accidental poisoning. [3] Chronic arsenic exposure causes chronic arsenicosis. The World Health Organization (WHO) [1] describes algorithm using following two diagnostic criteria of arsenicosis: a. The presence of pigmentary and keratotic skin lesions and b. Evidence of exposure to elevated levels of arsenic established by the history of intake of arsenic contaminated water, or by arsenic concentration in hair or nails. The first diagnostic criteria are clinical criteria, which require the presence on physical examination of any of the pigmentary or keratotic skin signs. The second criteria are laboratory criteria, INTRODUCTION Arsenicosis is a chronic health condition arising from prolonged ingestion of arsenic above the safe dose for at least 6 months, usually manifested by characteristic skin lesions of melanosis and keratosis, occurring alone or in combination, with or without the involvement of internal organs. [1] Arsenic exposure occurs in variety of occupations, during work in industries and during use of weed killer or insecticides and different chemical compounds. However, arsenic-containing groundwater intake is the main cause of arsenic toxicity now. About 25 million people of Bangladesh and a similar number of people of surrounding countries are at threat of arsenic- contaminated drinking water. [2] Hence, described as the Bangladesh arsenic condition, “largest mass poisoning in the world.” Arsenic exposure causes different types of toxic effect to human. Acute arsenic poisoning with an ingested dose of only 70–180 mg of arsenic trioxide is fatal to human. Acute arsenic ABSTRACT Background: Chronic arsenicosis is a serious health problem in Bangladesh now due to the intake of arsenic contaminated groundwater above the safe level of 0.05 mg/L by shallow tube well, throughout the country. About 25 million people of Bangladesh are at risk of chronic arsenic toxicity. Arsenic toxicity is also an alarming situation in many countries of the world. Hence, the study on health hazard of arsenic contamination, its prevalence, presentation, complication, and management is an important one. Aim: The purpose of this study is to evaluate different cutaneous and mucous membrane manifestations of chronic arsenicosis. Method: The study descriptive was conducted in the Department of Dermatology and Venereology in Chittagong Medical College Hospital. A total 105 patients of clinically diagnosed chronic arsenicosis were selected for the study. Clinical manifestations of chronic arsenicosis patients were analyzed for different mucocutaneous findings. Result: Evaluation and analysis of findings showed chronic arsenicosis patients had characteristic features of melanosis or leukomelanosis (raindrop pigmentation) in 100% patients. Another characteristic finding of palmoplantar punctate hyperkeratosis was found in 69.5% of patients of chronic arsenicosis. Other mucocutaneous findings of chronic arsenicosis were cutaneous malignancy such as basal cell carcinoma, squamous cell carcinoma, and Bowen’s disease. Others cutaneous and systemic diseases were also observed in patients of chronic arsenicosis. Conclusion: Characteristic mucocutaneous findings of chronic arsenicosis were melanosis, leukomelanosis (raindrop pigmentation), palmoplantar punctate hyperkeratosis, and cutaneous malignancy. As chronic arsenicosis is a serious health problem in our country, it demands more research on chronic arsenicosis. Key words: Chronic arsenicosis, leukomelanosis, melanosis, pigmentation Different cutaneous and mucous membrane manifestations of chronic arsenicosis, a study of Chittagong, Bangladesh Ashek Elahi 1 , Mansurul Alam 1 , Ashraful Islam 2 , Golam Faruk 3 , Taslima Akter 4 , Mizanur Rahman 5 * 1 Department of Dermatology, Cox’s Bazar Medical College, Cox’s Bazar, Bangladesh, 2 Department of Anatomy, Cox’s Bazar Medical College, Cox’s Bazar, Bangladesh, 3 Department of Anatomy, Chittagong Medical College, Chittagong, Bangladesh, 4 Department of Obstetrics and Gynecology, International Medical College, Chittagong, Bangladesh, 5 Department of Biochemistry and Molecular Biology, University of Chittagong, Bangladesh Address for correspondence: Mizanur Rahman, Department of Biochemistry and Molecular Biology, University of Chittagong, Bangladesh. Phone: 880- 1819334298/01760700767. E-mail: mizan2011bio@gmail.com Received:15-02-2018 Revised:05-3-2018 Accepted:31-03-2018 ORIGINAL ARTICLE e-ISSN: 2349-0659 p-ISSN: 2350-0964 doi: 10.21276/apjhs.2018.5.1.44