INTRODUCTION Arsenic is an ubiquitous element in nature. Contamination of water can occur naturally when arsenic-rich ores leach into ground and surface water (1). Chronic ingestion of water with high concentrations of arsenic cause adverse health effects to human beings. Keratosis, hyperpigmentation, and depigmentation are the most common cutaneous lesions and play important roles in the diagnosis of arsenic poisoning (2-5). Furthermore, cutaneous lesions are often viewed as useful precursors of severe diseases such as skin cancer (6).