Danza Cristiana

Journal of Pakistan Association of Dermatologists 2014;24 (2):156-159, 2014

Objective To determine the frequency of cutaneous changes in patients with chronic kidney disease on maintenance hemodialysis. Methods A cross-sectional study conducted A total of 100 patients with chronic kidney disease on maintenance hemodialysis were included. After taking demographic data, cutaneous changes were noted. Mean and standard deviation were computed for quantitative variables (age) and frequency and percentage were computed for categorical variable (sex, cutaneous changes). Results Mean age was 52.58±13.84 years and out of 100 patients 56% were males. At least one skin change was noted in 91%. Among type of manifestations, xerosis was noted in 96%, generalized xerosis 70%, alopecia 70%, half-and-half nails 36%, scaling 20% and ichthyosis 10%. Pruritus was found in 64%, out of these 93% had mild to moderate intensity and 7% had severe intensity of pruritus. Conclusion Chronic kidney disease is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. Xerosis and pruritus were most common among patients with CKD, so early recognition of cutaneous signs can relieve suffering and decrease morbidity.

Jornal Brasileiro de Nefrologia, 2014

Cutaneous and mucosal disorders are the most common problems in patients on long-term hemodialysis. The dialysis prolongs the life expectancy, giving time of these changes to manifest. The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal disease (CRD) undergoing hemodialysis. Methods: One hundred forty-five patients with chronic renal disease undergoing hemodialysis were studied. All patients were thoroughly examined for skin changes, hair, nails and mucous membranes by a single examiner and laboratory tests were assessed. The data were stored in a database Microsoft Excel and analyzed using descriptive statistics. The continuous variables were compared using Student's t-test and categorical variables the chi-square test or Fisher's Exact test. Results: The study included 145 patients, mean age of 53.6 ± 14.7 years, predominantly male (64.1%) and caucasian (90.0%). The average time of dialysis was 43.3 ± 42.3 months. The main underlying diseases were: hypertension in 33.8%, diabetes mellitus in 29.6% and chronic glomerulonephritis in 13.1% of the patients. The main dermatologic manifestations observed were: xerosis in 109 (75.2%), ecchymosis in 87 (60.0%), pruritus in 78 (53.8%) and lentigo in 33 (22.8%) patients. Conclusion: Our study showed the presence of more than one alteration per patient. Cutaneous alterations are frequent in patients on dialysis. Further studies are needed to better characterization and management of these dermatosis.

International Journal of Research in Dermatology, 2017

INTRODUCTION Chronic kidney disease (CKD) is defined as presence of kidney damage, manifested by abnormal albumin excretion or decreased kidney function, quantified by measured or estimated glomerular filtration rate (GFR) that persists for more than 3 months. Chronic kidney disease is major health problem. Hemodialysis is the standard treatment for these patients. Chronic kidney failure presents with an array of cutaneous manifestations. The number of CKD patients continue to rise, reflecting growing elderly population and increasing numbers of patients with diabetes and hypertension. 1 Hence we undertook this study to analyse the pattern of cutaneous manifestation in patients with CKD on hemodialysis in our population. METHODS Patient attending Dermatology and Nephrology OPD of Sri Manakula Vinayagar Medical College & Hospital with chronic renal failure from November 2014 to May 2016 was included in the study. After getting informed consent a detailed history of the patient and examination was entered in a pre-prepared proforma. The demographic characteristics were recorded and the ABSTRACT Background: Chronic kidney disease is defined as presence of kidney damage, manifested by abnormal albumin excretion or decreased kidney function, quantified by measured or estimated glomerular filtration rate (GFR) that persists for more than 3 months. Chronic kidney disease is major health problem. Chronic kidney failure presents with an array of cutaneous manifestations. The objective of the present study was to determine the pattern of mucocutaneous manifestations of chronic renal failure on hemodialysis. Methods: A cross sectional study done in the Dermatology & Nephrology OPD of Sri Manakula Vinayagar Medical College and Hospital from October 2014 to May 2016. About 38 consenting patients who fulfilled the inclusion criteria were chosen for the study. The demographic characteristics were included in the study and the clinical profile of the patient such as hematological investigation and renal function tests were assessed. KOH mount, skin biopsy, Woods lamp, Grams stain and culture & sensitivity were done if needed after getting informed consent from the patients. Results: The most common cutaneous manifestations in haemodialysis patients were xerosis and uraemic pruritus. Conclusions: Cutaneous manifestations like uraemic pruritus, Xerosis, Kyrle's disease, infections, icthyosis & other lesions were seen with Xerosis beimg the most common feature. At least one cutaneous manifestation is found in all CRF patients.

2015

Background. Hemodialysis patients experience frequent and various cutaneous manifestations of often hypothetical pathogenesis. Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Objective. To evaluate the prevalence and nature of cutaneous lesions, associated with CRF patients on hemodialysis in Egyptian patients. Patients and methods. One hundred patients with CRF on regular hemodialysis from nephrology units were examined for cutaneous changes. Specific investigations like skin biopsy, culture and sensitivity for bacterial infections, potassium hydroxide mount and fungal culture were done when indicated. Results. All patients included in this study had at least one cutaneous manifestation attributable to CRF. The most prevalent findings was pruritus (55%), followed by xerosis (54%), hyperpigmentation (54%) and pallor (45%). Other cutaneous manifestations were wrinkles (40%), fungal infections (33%), ecchymosis (27%), dermatitis (23%), yellow face (22%)...

Journal of Pre-Clinical and Clinical Research

Introduction. A wide variety of skin diseases occur in patients with chronic renal failure (CRF). These diseases are either related to the underlying chronic kidney disease (CKD) or to its treatment modalities like hemodialysis (HD) and renal transplant (RT). The studies comparing cutaneous manifestations in CKD, CKD with HD and RT recipients (RTR's) have been limited. Material and methods. 106 patients with CKD, 101 patients with CKD and who are undergoing HD and 80 RTR's having at least one dermatological complaint formed the study groups. Detailed cutaneous examination was done for all patients and dermatological manifestations were compared among various study groups. Results. The most prevalent finding in CKD patients was xerosis (69%) followed by pruritus (67%) and pigmentation disorders (11%). Other cutaneous manifestations included acquired perforating diseases(APD) (7.5%); fungal (9.4%), viral (7%) and bacterial (2%) infections and nail changes(11%).The manifestations found in CKD patients on HD were xerosis (65%) followed by pruritus (62%),pigmentation disorders (20%), APD (6%); fungal (9.9%), viral (4%) and bacterial (5%) infections and nail changes(19%). In RTR's, however, infections (47%) were the most prevalent finding. Others were xerosis(20%), pruritis(9%),pigmentation disorders(5%),APD (1%),nail changes(5%) and lesions of aesthetic interest(14%). Manifestations like pruritus, xerosis, hyperpigmentation and infections differed significantly when compared amongst three groups. Conclusions. Cutaneous manifestations are common and different in CKD, HD and RTR group of patients. While xerosis and pruritus were common in CKD and HD group, infections were most prevalent in RTRs.

IOSR Journals , 2019

Background: End Stage Renal Disease(ESRD) 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. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with End Stage Renal Disease (ESRD) undergoing hemodialysis. Methods: One hundred patients with ESRD on hemodialysis were examined for cutaneous changes. Results: Eighty-two per cent patients complained of some dermatologic problem. However, on examination, all patients had atleast one skin lesion attributable to ESRD. The most prevalent finding was xerosis(79%), followed by pallor(60%), pruritus(53%) and skin pigmentation(43%).other dermatologic manifestations include 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 ESRD like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were also observed. Conclusions: ESRD is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and prutitus and the early recognition of dermatologic manifestations can relieve suffering and decrease morbidity.

Seminars in Dialysis, 2012

Cutaneous abnormalities in patients with end-stage renal disease (ESRD) receiving hemodialysis or peritoneal dialysis may demonstrate signs of their underlying condition or reveal associated disease entities. While a thorough examination of the scalp, skin, mucosa, and nails is integral to establishing a diagnosis, certain conditions will resolve only with dialysis or improvement of their renal disease and others may not require or respond to treatment. Half and half nails, pruritus, xerosis, and cutaneous hyperpigmentation are common manifestations in ESRD. With hemodialysis, uremic frost is no longer prevalent in ESRD patients and ecchymo-ses have decreased in incidence. Acquired perforating dermatoses are seen in over one-tenth of hemodialysis patients. Metastatic calcinosis cutis and calciphylaxis are both rarely reported, although the latter is seen almost exclusively in the setting of hemodialysis. Diagnosis of nephrogenic systemic fibrosis has historically been challenging; as such, new diagnostic criteria have been proposed. Blood porphyrin profiles are needed to differentiate between porphyria cutanea tarda and pseudoporphyria. We will review and provide an update on the aforementioned common cutaneous manifestations of ESRD in patients receiving dialysis.

Journal of Evolution of Medical and Dental Sciences, 2016

BACKGROUND The kidneys and the skin are two important organs whose blood supply far exceeds their demand, the former for maintaining the milieu interior and the latter for rendering man homoeothermic. Changes of the skin are frequently seen in patients with kidney disease and in those who are undergoing dialysis. A number of diseases are characterised by distinctive cutaneous and renal manifestations. MATERIALS AND METHODS This study spanned a course of 6 months from January 2011 to June 2011. During this period 82 patients admitted in the Nephrology ward of Osmania General Hospital for dialysis as well as those patients referred to the Dermatology Outpatient Department from the Nephrology Department were screened for evidence of cutaneous manifestations of kidney disease. Of these, 50 patients who had the presence of skin manifestations were selected and studied, both sexes and all age groups were included in the study. RESULTS Out of 50 patients in the age group of 1-70 years, (66%) maximum number of patients were observed between 3rd to 5th decade while least number in 1st and 2nd decade. Youngest Patient studied-Male, 7 Years. Oldest patient studied-Male, 69 Years. Xerosis or dryness of the skin was seen in 28 patients. 14 patients out 50 showed pallor. Pruritus was seen in 12 patients. Purpura was seen in 3 patients. Perforating dermatoses was seen in 3 patients. Fungal infections were seen in 9 patients. Bacterial infections were seen in 5 patients. Viral infections were seen in 4 patients. Scabies was seen in 2 patients. Sparse scalp hair was reported in 7. Specific nail changes were seen in 19 patients. CONCLUSIONS Among the various cutaneous manifestations, xerosis and pigmentary changes topped the list of prevalence with Xerosis 56%, Pallor 28%. Pruritus was seen in 24% of patients. Nearly, 6% had perforating dermatosis. The Prevalence of hair abnormalities in our study was 14%. Prevalence of nail changes were seen in 38% of cases. Cutaneous infections were seen in 36% of patients.

2015

Background: Skin is often considered as a mirror of internal diseases. Many systemic diseases produce cutaneous manifestations before or after the onset of systemic events. Patients with Chronic Kidney Disease (CKD) are often burdened by skin lesions, these findings can prompt for early diagnosis of CKD and its management. Material & Methods: A total of 150 cases of CKD with or without hemodialysis were studied for a period of 18 months. Detailed cutaneous examination was done and dermatological manifestations were evaluated and compared among dialysis and pre-dialysis groups. Results: 97 patients were in Dialysis group and 53 in Pre-dialysis group. Xerosis(62%)was most common followed by pallor(31.3%), pruritus (28%), pigmentation (25%), infections (13.3%), purpura & ecchymoses(12.7%), absent lunula(11%), xerostomia (11%), eczema(9.3%), leukonychia (8%), perforating disorders(7.3%), half & half nails (7%). Bullous disorders and nephrogenic systemic fibrosis were encountered less of...