Dermatological Manifestations in Patients of Chronic Kidney Disease (CKD)

Abstract

Background: CKD is associated with various mucocutaneous manifestations that impair the quality of life.The objective was to study the incidence of various cutaneous manifestations in CKD patients.Materials and Method: 130 (M:F = 4.2:1) patients aged 15?78 (Mean age- 50.32 years) having CKDfor 3 month to 5 years were studied for mucocutaneous manifestations. Forty (30.7%) patients were onhemodialysis for 1-3 months. Detailed medical history, clinical and mucocutaneous examination and labinvestigations were performed. KOH mounts, skin biopsy, Gram’s and Giemsa staining, bacterial or fungalcultures were performed as required.Results: Xerosis in 104 patients (80%), skin pallor in 76(58.4%), pruritus in 52 (50.9%) patients, pigmentationin 45(34.6%) and purpura in 12 (9.2%) patients were the major dermatoses. Perforating folliculitis occurredin1 (0.76%) patient..Mucosal findings included coated tongue in14(11.66%), xerostomia in 11(9.16%) andmacroglossia with teeth markings and fissured tongue in 9 (7.5%) patients each, angular cheilitis in 3 (2.5%),and aphthous stomatitis and black pigmented tongue in 1 (0.83%) patients each. Hair abnormalities includedsparse scalp and body hairs in 43 (33%), 11 (8.4%), respectively and lusterless hair in 22 (16.9%) patients.Major nail abnormalities were half and half nails or Linday’s nails in 33(25.3%), longitudinal ridging in29(22.3%), leuconychia in 13(10%), onycholysis in 9(6.9%), Beau’s lines in 6(4.6%), koilonychias in4(3.07%), Mee’s lines in 1(0.76%) and Meuhrcke’s lines in 1(0.76%).Conclusions: Xerosis, pruritus, skin pallor/pigmentary changes, half and half nails, longitudinal ridging,discoloration, sparse hairs, coated tongue, xerostomia, macroglossia, and infections were the most commonmucocutaneous manifestations in the studied patients irrespective of hemodialysis status.