Background
Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes
are being described since the advent of hemodialysis (HD), which prolongs life expectancy,
providing time for these changes to manifest.
Objective
The aim of this study was to estimate the prevalence and pattern of cutaneous manifestations
among patients with CRF on regular HD.
Patients and methods
This case-series study included 100 patients with CRF on regular HD. They were subjected
to a full assessment of history, and general and dermatological examinations of the skin, hair,
nails, and oral mucosa.
Results
All patients included in this study had at least one cutaneous manifestation attributed
to CRF. The most prevalent finding was xerosis (72%), followed by pruritus (52%) and
hyperpigmentation (44%), whereas purpura (2%) and bullous dermatosis (1%) were the least
detected. Oral changes included xerostomia (46%), macroglossia with teeth markings (43%),
fissured tongue (17%), ulcerative stomatitis (11%), and angular cheilitis (6%). The most
common nail changes were absent lunula (61%), half and half nail (41%), and koilonychia
(29%). Hair changes included sparse scalp hair (48%), sparse body hair (41%), and brittle
and lusterless hair (39%). Hypertension and diabetes mellitus were the most common causes
of CRF (53 and 18%, respectively).
Conclusion
Every CRF patient on HD had at least one cutaneous manifestation, which may appear
before or after HD. The most common cutaneous manifestations were xerosis, pruritus,
hyperpigmentation, xerostomia, macroglossia, absent lunula, half and half nail, sparse scalp
hair, and sparse body hair.