Cutaneous manifestations in patients with chronic renal failure on hemodialysis.
BACKGROUND
Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest.


OBJECTIVE
The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF) undergoing hemodialysis.


METHODS
One hundred patients with CRF on hemodialysis were examined for cutaneous changes.


RESULTS
Eighty-two per cent patients complained of some skin problem. However, on examination, all patients had at least one skin lesion attributable to CRF. The most prevalent finding was xerosis (79%), followed by pallor (60%), pruritus (53%) and cutaneous pigmentation (43%). Other cutaneous manifestations included Kyrle's disease (21%); fungal (30%), bacterial (13%) and viral (12%) infections; uremic frost (3%); purpura (9%); gynecomastia (1%); and dermatitis (2%). The nail changes included half and half nail (21%), koilonychia (18%), onychomycosis (19%), subungual hyperkeratosis (12%), onycholysis (10%), splinter hemorrhages (5%), Mees' lines (7%), Muehrcke's lines (5%) and Beau's lines (2%). Hair changes included sparse body hair (30%), sparse scalp hair (11%) and brittle and lusterless hair (16%). Oral changes included macroglossia with teeth markings (35%), xerostomia (31%), ulcerative stomatitis (29%), angular cheilitis (12%) and uremic breath (8%). Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were also observed.


CONCLUSIONS
CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.
Udayakumar
P
P
Department of Dermatology, PSG Hospitals, Peelamedu, Coimbatore, India.
Balasubramanian
S
S
Ramalingam
K S
KS
Lakshmi
Chembolli
C
Srinivas
C R
CR
Mathew
Anil C
AC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006201:Hair Diseases / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009260:Nail Diseases / Q000209:etiology; D010859:Pigmentation Disorders / Q000209:etiology; D011537:Pruritus / Q000209:etiology; D006435:Renal Dialysis; D012871:Skin Diseases / Q000209:etiology*; D012874:Skin Diseases, Infectious / Q000209:etiology