title: Cutaneous abnormalities in patients with end stage renal failure on chronic hemodialysis. A study of 458 patients.
abstract: BACKGROUND
  Cutaneous manifestations occurring in patients with end stage renal failure on hemodialysis are polymorphic and diverse.
  
  
  OBJECTIVE
  The aim of our study was to assess the prevalence and characteristics of different cutaneous manifestations in patients on hemodialysis.
  
  
  METHODS
  We led a transverse investigation of all patients on hemodialysis in 12 haemodialysis centres of Sfax (Tunisia). We examined 458 patients (254 men and 204 women). The hemodialysis history ranged from 6 months to 24 years. A total of 394/458 (86%) patients had cutaneous abnormalities. These included pruritus (56.6% of patients), paleness (60.7%), xerosis (52.8%), hyperpigmentation or hypopigmentation (38.4%), venous dilation near the fistula (22.2%), eczema in the fistula area (14.8%), half-and-half nails (13.5%), onychodystrophy (6.1%), subungual hemorrhage (4.5%), leukonychia (4.5%), stomatitis (5.6%), xerostomia (3.2%), gingivitis (2.4%), uremic breath (2.1%), and skin calcificatins (0.4%). Nephrogenic fibrosing dermopathy was not detected in any of our patients.
  
  
  CONCLUSIONS
  Pruritus, paleness, dry skin as well as hyperpigmentation and hypopigmentation are the most frequent skin abnormalities observed in hemodialysis patients. The early recognition of some cutaneous conditions associated with end stage renal failure and hemodialysis may allow early therapeutic intervention and decrease morbidity.
authors.affiliation: Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia;
authors.forename: Abderrahmen
authors.initials: A
authors.lastname: Masmoudi
authors.affiliation: Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia;
authors.forename: Mounira
authors.initials: M
authors.lastname: Hajjaji Darouiche
authors.affiliation: Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia;
authors.forename: Haifa
authors.initials: H
authors.lastname: Ben Salah
authors.affiliation: Department of Nephrology, Hedi Chaker Hospital, Sfax, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ben Hmida
authors.affiliation: Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia;
authors.forename: Hamida
authors.initials: H
authors.lastname: Turki
keywords: adverse events; dry skin; hemodialysis; kidney; pruritis; xerosis