English

Abstract

AIM OF THE STUDY: To study the different clinical patterns of cutaneous lesions in chronic renal failure patients undergoing haemodialysis. To study the distribution of lesions seen more often in both the skin and nails. To study the epidemiology of patients with cutaneous manifestations with CRF on haemodialysis in relation to age, sex and predisposing factors. PATIENTS AND METHODS: The study was conducted at Kempegowda Institute Of Medical Sciences, Bangalore between November 2009 and April 2011 for a period of 18 months. This prospective and Descriptive study included 100 patients with CRF who were undergoing dialysis. Of the 100 patients , 61 were Males and 39 were Females and the age ranged from 16 years to 70 years, with the majority of them in the age group of 41 to 60 years. The predominant cause of CRF was Diabetic Nephropathy (50%) followed by Chronic Glomerulonephritis (24%) and Chronic Interstitial Nephritis (19%). RESULTS: The predominant cutaneous manifestations included Xerosis (50%), Pruritis (38%), Cutaneous Pigmentation (36%), Nail Changes (42%), and Mucosal Changes (20%) Pallor (23%), Cutaneous Infections (27%) and Perforating Dermatoses (6%). The most common Nail Change was Leukonychia, observed in 22 patients and the most common cutaneous infection was fungal infection observed in 16 patients. The Nail Changes documented in the study included Leukonychia (22%), Dystrophic Nails (6%), Onychomycosis (8%), Half & Half Nails (5%), Clubbing (2%), Paronychia (2%), Beau's Lines (1%) and Mee's Lines (1%). The cutaneous findings specific to CRF including Perforating Dermatoses (6%), Calcinoses Cutis (2%), Beau's Lines (1%), Mee's Lines (4%) and Gynecomastia (1%) were also documented in the study. The incidence of Pruritus, Xerosis and Diffuse Hyperpigmentation increased as the severity of CRF increased. The incidence of xerosis, diffuse hyperpigmentation and nail Changes was significantly more in patients undergoing more than 100 dialysis. CONCLUSION: The incidence of pruritus decreased significantly as the total number of dialysis is increased to more than 100, as compared to those with less than 50 dialysis. The incidence of pruritus, xerosis and diffuse hyperpigmentation increased as the severity of CRF increased.