Half Nails Research Articles

Clinical Image: Half and half nails in lupus nephritis.

Clinical Image: Half and half nails in lupus nephritis.

Nail involvement in connective tissue diseases: an epidemiological, clinical, and dermoscopic study.

The assessment of nail changes in connective tissue diseases (CTD) has been rarely explored in previous studies. The use of dermoscopy to study vascular changes in nailfolds is an interesting diagnostic technique. The aim of the study was to describe the epidemiological, clinical, and dermoscopic features of nail lesions in CTD. A prospective study was performed at the Dermatology Department of Habib Thameur Hospital (Tunis, Tunisia) in collaboration with the Internal Medicine Department over a period of 15 months, from July 2020 to September 2021, including patients diagnosed with systemic sclerosis (SS), systemic lupus erythematosus (SLE) and dermatomyositis (DM). Our study included 48 patients. Nail involvement was found in 44 cases. Dermoscopic nailfold abnormalities were identified in 37 cases. The most common clinical features were ragged cuticle, nailfold erythema, and onycholysis. Additionally, splinter hemorrhage, longitudinal ridging, lunula abnormalities, melanonychia, trachyonychia, leukonychia, increase in transverse curvature, parrot beak nail, half and half nails, and onychorrhexis were described. Nailfold dermoscopy showed a normal pattern in 10 cases, a nonspecific pattern in nine cases (SLE), and a scleroderma pattern in 29 cases (SS and DM). The scleroderma pattern was further categorized into an early pattern (6), an active pattern (14), and a late pattern (9). Normal pattern was observed solely in patients in remission. The late scleroderma pattern was associated with disease duration and systemic involvement. In SLE, disease activity correlated with onycholysis, nailfold erythema, and pathologic pattern in dermoscopy. However, patients with DM displayed a positive correlation between pulmonary involvement and scleroderma pattern. Nail involvement in CTD includes a diverse range of abnormalities. Despite being nonspecific, it can provide crucial clues for establishing a diagnosis. Nailfold dermoscopy serves as a mirror for microangiopathy, enabling the detection of changes at an initial stage, and thus, it becomes a diagnostic and prognostic tool.

A Descriptive Study of Nail Changes in Systemic Diseases

Abstract Background and Objectives: Nail findings may represent a part of the symptom complex that may be useful for the physical diagnosis. Thus, the present study was undertaken to know the nail changes in systemic diseases among patients attending the outpatient and inpatient departments of dermatology, medicine, nephrology, pulmonology, and surgery attached to Karnataka Institute of Medical Sciences (KIMS), Hubballi. Methodology: A hospital-based original study was conducted at KIMS, Hubballi. During January 1, 2021–January 30, 2023, data were collected by personal interview after obtaining informed consent from all eligible participants using a prestructured and pretested pro forma, among a convenient sample of 272 patients selected by the simple random sampling method. Results: Among 272 patients, 57.5% of the patients were young adults with male predominance (56.0%) and inpatients (66.0%) were more compared to outpatients (44%). Of the 272 patients, respiratory system (RS) (26%) was most common involved followed by hematology (21.0%), gastrointestinal tract (GIT) and liver (17%), cardiovascular system (CVS) and renal (12%), and clubbing was the most common nail change encountered (35.5%) followed by longitudinal ridging (33%) and pallor (31%) of the nail subsequently. RS was found as the common cause of clubbing followed by CVS and liver and GIT. Conclusion: RS (clubbing) was the most common system involved. Other systems involvement were renal system (half and half nail), liver, and GIT system (Terry’s nail) which are the specific nail changes that can lead us to the diagnosis. Thus, nails can serve as a window for the underlying systemic illness.

Half and Half Nail (Lindsay’s Nail) for Prediction of Biochemical Disorders and Unveiling its Etiopathogenesis in Chronic Kidney Disease Stage 5

Half and Half Nail (Lindsay’s Nail) for Prediction of Biochemical Disorders and Unveiling its Etiopathogenesis in Chronic Kidney Disease Stage 5

A Study of Mucocutaneous Manifestations in Patients with Chronic Kidney Disease

Background: Chronic renal failure is associated with diverse mucocutaneous manifestations as a result of underlying etiology as well as due to various treatment modalities which can significantly impair the quality of life. Aim: To study the clinicodemographic profile of Chronic Kidney Disease (CKD) patients and to compare the cutaneous manifestations in CKD both on dialysis and pre-dialysis group. Methods: This study was carried out in the Department of Dermatology, Venereology and Leprology, Medicine and Dialysis unit at Shree Krishna Hospital, Karamsad, Anand. One hundred and twenty patients with CKD were examined for mucocutaneous changes over a period of one year. The descriptive statistics was used to describe the quantitative data and the qualitative data was presented using frequency and analyzed using Chi Square test. Result: All one hundred and twenty patients had at least one mucocutaneous condition due to CRF. The most prevalent finding was xerosis (34 Pre-dialysis+ 31 Dialysis) 65(54.2%), followed by pruritus (33 Pre-dialysis+ 24 Dialysis) 57(47%), pallor (6 Pre-dialysis+21Dialysis) 27(22.5%) and cutaneous pigmentation (10 Pre-dialysis+14 Dialysis) 24(20%). Other cutaneous manifestations included fungal 10(8.3%), viral 9(7.5%) and bacterial 7(5.8%) infections, purpura 9(7.5%),perforating disorder 6(5%),uremic frost 1 (0.83%).The nail changes included onychomycosis 5(4.2%), koilonychia 4(3.3%),half and half nail 2(1.7%), subungual hyperkeratosis 2(1.7%) and onycholysis 2(1.7%). Hair changes included brittle and lusterless hair 21(17.5%), sparse scalp hair 10(8.3%) and sparse body hair 8(6.7%). Oral changes included xerostomia 15(12.2%), ulcerative stomatitis 4(3.3%) and angular cheilitis 4(3.3%). Conclusion: The most common mucocutaneous manifestations in the patients under our study were xerosis and pruritus, irrespective of hemodialysis status. Early recognition and treatment can reduce morbidity and improve these patients' quality of life. In all such patients, lifelong follow up is needed.

Frequency of Nail Deformities in Patients with Chronic Kidney Disease Undergoing Hemodialysis

Background: Nail disorders are common in patients with chronic kidney disease on maintenance hemodialysis. Even though there are some studies regarding nail disorders in peritoneal dialysis and renal transplant patients, to the best of our knowledge, sparse local data is present on nail disorders among maintenance hemodialysis patients. Aim: To determine the frequency of nail disorders in patients with chronic kidney disease on maintenance hemodialysis. Study design: Cross-sectional study Place and duration of study: Dept of Nephrology, Sir Ganga Ram Hospital, Lahore from 1st February 2019 to 1st August 2019. Methodology: Two hundred and ninety two cases were enrolled. The nails of the patients were inspected and shot by utilizing a 10-megapixelcamera. The photos were subsequently reviewed independently by two dermatologists and one nephrologist. Results: There were 198 (67.8%) males and 94 (32.2%) females. The mean age was 47.3±12.4 years. The overall frequency of nail disorder in patients with chronic kidney disease on maintenance hemodialysis was 197(67.5%). According to nail disorders distribution, 119(40.8%) had half and half nail, while 56(19.2%) had splinter hemorrhage, 47(16.1%) had absent lunula, 16 (5.5%) had chromonychia, 15(5.1%) had Beau’s line, 19(6.5%) had melanonychia and 52(17.8%) had onycholysis. Conclusion: The frequency of nail problems in CKD patients treated by hemodialysis is 67.5%. This finding highlights the need for nail evaluation as a component of periodic examination in hemodialysis patients. Key words: Chronic kidney disease, Haemodialysis, Nail disorders.

Nail Changes in the Chronic Kidney Failure – A Cross-Sectional Study

Background: Nail manifestations observed in chronic renal failure (CRF) patients are multifarious and heterogeneous in nature. The prime objective of the study is to evaluate the prevalence and features of various kinds of nail manifestations in the patients of CRF. CRF causes heterogeneous pathology of nail which may be or may not be associated with renal condition itself, complications related to it and its therapy. Objective: To study nail changes in the patients of CRF whether managing conservatively or on maintenance hemodialysis (HD). Patients and Methods: The study consists of 100 patients suffering from CRF. Nails of these 100 patients suffering from CRF were examined and different kinds of nails were appreciated and frequencies of the same type of nails in different patients were noted. Results: Nail changes found in chronic kidney disease are longitudinal ridges, half and half nails, leukonychia, pitting nails, onychomycosis, absence of lunula, splinter hemorrhage, and onycholysis as decreasing trend they observed. Conclusions: Nail changes that are seen on examination of patients with CRF managing on HD are very frequent and nail changes if found earlier can be an indicator for early diagnosis of systemic diseases.

Prevalence of Chronic Kidney Disease, Its Risk Factors and Outcome in Nepal: A Systematic Review and Meta-analysis.

Hypertension, diabetes, glomerulonephritis, obesity, and family history of kidney diseases are major risk factors for chronic kidney disease. Due to the paucity of data on a national level regarding the prevalence, risk factors, and complications of chronic kidney disease, we performed this meta-analysis. We searched online databases from January 2000 till October 2020. Two reviewers screened articles using Covidence software. Comprehensive Meta-Analysis Software version 3 was used for data analysis. Among chronic kidney disease patients, 35.96% were found to have high LDL, 34.22% had hypercholesterolemia, 39.18% had hypertriglyceridemia, and 42.23% had low HDL. Pigmentary changes were reported in 37.71%, pruritus in 30.96%; and xerosis in 48.55%. Among the reported nail problems, the brown nail was reported in 7.19%, half and half nail in 6.07%, and white nail in 20.65%. The prevalence of chronic kidney disease among high-risk cohorts in Nepal was significant among risk group with hypertension and diabetes being the most common risk factors. The most common stage of chronic kidney disease was Stage V, and the common complications were skin problems and dyslipidemia.

Common mucocutaneous manifestations of patients with End Stage Renal Disease: A comprehensive review study

One of the notable points in ESRD patients is the multiplicity of skin manifestations which can include a wide range. It can also affect the living standards of patients due to its many types and severity. Careful study, as well as intense follow-up of these manifestations, can help physicians in timely diagnosis and their control or treatment. In this study, we tried to study the common mucocutaneous manifestations that occur in these patients. All references can be searched from PubMed. Sources of this study have been studied for clinical manifestations, pathophysiology, and treatment of skin manifestations in ESRD patients. In this study, xerosis, pruritus, pigmentation disorders, half and half nails, perforating disorder, and skin infections as well as appendageal disorders (hair and nail) in ESRD patients have been studied. These can be associated with other diseases and increase by disease severity. For better results and more help to patients with this disease, it seems that more and more comprehensive studies are needed. Key words: End stage renal disease, ESRD, mucucutaneous, skin, dermatology, xerosis, pigmentation disorders, infection, perforating disorder, half and half nails

Mucocutaneous manifestations of patients with chronic kidney disease under hemodialysis: A cross-sectional study of 49 patients.

Chronic kidney disease (CKD) is a common medical problem with well-known dermatologic manifestations, some of which highly disturb the patients' quality of life. This cross-sectional study was designed to identify the prevalence and type of cutaneous involvement in CKD patients. The skin manifestations of 49 patients with CKD undergoing hemodialysis at Akhavan Hospital in Kashan, Iran, were recorded over 2 months. Diabetes (35%) was the most common cause of chronic renal failure in the patients, and the most common skin manifestations were xerosis (95.9%), uremic pigmentation (89.8%), scleral discoloration (87.8%), dental discoloration (85.2% among the patients with natural teeth), dry mouth (65.3%), varicosity (61.2%), pruritus (57.1%), skin atrophy (49%), lentigo (46.9%), subungual hyperkeratosis (42.9%), half and half nail dystrophy (34.7%), and purpura (26.5%). Mucocutaneous involvement has a very high prevalence in CKD patients undergoing hemodialysis, and some of the cases are medically and cosmetically disturbing; therefore, with better knowledge about the type and prevalence of these involvements, the consequences can be better predicted and managed. Further studies are recommended to be conducted on the association between these signs and CKD grade, and clinical trials are also required for establishing the treatment options available for these signs and then assessing the patients' quality of life as a primary outcome measure.

Dermatological Manifestations in Patients of Chronic Kidney Disease (CKD)

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.

Prevalence of foot disorders according to chronic kidney disease stage.

Chronic kidney disease (CKD) is a public health disease that affects 15.1% of the adult population. Although a high prevalence (94.1%) of skin disorders has been detected in people on haemodialysis or with advanced CKD, few studies have analysed foot disorders at initial CKD stages. To analyse the prevalence of foot disorders according to CKD stage. A total of 209 people with a mean age of 73.2 ± 13.8 years (52.0% women) in the nephrology department of Virgen del Puerto Hospital, Plasencia (Spain) were examined from January 2018 to April 2019. CKD stages were determined by nephrologists according to the Kidney DiseaseImproving Global OutcomesGuideline. An expert podiatrist identified foot disorders. Data were statistically treated with the IBM SPSS Statistics. Comparisons between variables were analysed by the χ2 test or Fisher's exact test, with a significance level of less than 5%. The prevalence of foot disorders was high for skin disorders (97.6% dermatopathies and 66.0% keratopathies), nail disorders (98.5% onychopathies) and toe deformities (97.1%). People at initial and intermediate stages presented more keratopathies (hyperkeratosis at G1 and G3a and pinch callus at G3a). Stage G1 showed fewer changes in nail colour and half and half nails. Stage G4 showed more claw toes and hematomaand stage G5 more Beau's lines, changes in skin colour, hematomasand thin shiny skin. The high prevalence of foot disorders detected in people with CKD requires specific and personalised professional care to relieve symptoms and avoid complications, helping to improve the quality of life of people with this condition.

Possible association between polycythemia and half and half nails

Half and half nail is a type of pseudoleukonychia characterized by proximal whitish areas that are sharply demarcated from red, pink, or brown areas distally on the nail bed. It often occurs in patients with chronic renal disease. Although cases of half and half nails with other diseases have been reported, the exact cause remains unclear. This is the first case report describing the possible association between polycythemia and half and half nails.

Cutaneous manifestations in patients with chronic renal failure on hemodialysis

Chronic renal failure (CRF) associated with many cutaneous manifestations starts from xerosis, dark pigmentation, to life threatening severe uncontrolled itching. Cutaneous problems with CRF having different and newer manifestations after hemodialysis interventions. To assess the prevalence of cutaneous manifestations including hair and nails in chronic renal failure (CRF) patients on hemodialysis . One hundred patients of CRF undertaking hemodialysis were examined for various cutaneous presentations. cutaneous manifestations seen in eighty six patients. The commonest finding was xerosis (81%),had wide range of clinical presentation with pruritus (56%) produced distress symptoms skin color changes presented commonly as pallor (65%), and cutaneous hyperpigmentation (53%) manifesting physical and psycological disturbance s respectively. Othera skin problem found peculiar to chronic renal failure are acquired perforating dermatoses of kyrles diease (20%); prevalence of cutaneous infections especially dermatophytosis and other superficial fungal infections (28%), pyoderma(10%) and viral (13%) infections; other important cutaneous manifestation are purpura (10%); and eczema(2%). The nail changes sharing significant presentations in majority of renal failure patients which included half and half nail (20%),as important clinical marker followed by koilonychia (16%), onychomycosis (16%), onycholysis (11%), Mees’ lines (7) Hair changes also contributing significant clinical finding as sparse body hair (27. Wide array of oral mucosal changes presented mainly as macroglossia (36%), xerostomia (28%), ulcerative stomatitis (27%), and uremic odour(7%). CRF had a significant cutaneous changes mainly as xerosis, pruritus acquired perforating dermatoses, uraemic odour and hyperpigmentation. These changes served as clinical clue in diagnosis and therapeutic management. These changes were attributed by disease (CRF) as well as hemodialysis. Management aimed as alleviation of sufferings and improve life quality.

Nail Changes Caused by Chemotherapy among Cancer Patients: A Cross-Sectional Study of Northwest Rajasthan.

Background:The nail changes caused by chemotherapy in cancer patients are difficult to assess and often overlooked by clinician. The present study was undertaken to study nail changes caused by various chemotherapeutic agents and various drug protocols most commonly associated with them.Materials and Method:Five hundred patients with malignancies receiving chemotherapy in the oncology ward and skin outpatient department were screened in this cross-sectional observational study from November 2018 to October 2019.Results:Nail changes due to chemotherapy were observed in 37.6% patients. The most common condition observed was melanonychia (84.04%), followed by half and half nails (6.91%), erythronychia (5.31%), longitudinal grooves (2.12%), leukonychia (2.12%), Mees’ lines (1.59%), Beau's lines (0.53%), pitting (0.53%), and subungual hyperkeratosis (0.53%). The usual protocol to cause melanonychia was platinum analogues + taxanes based combinations, half and half nails by platinum analogues + taxanes + 5 fluorouracil (5FU) based polypharmacy, and erythronychia by cisplatin-based adjuvants.Conclusion:The knowledge of the nail changes caused by chemotherapy will help in counseling of already worried patients with malignancy. It will also improve patient compliance and enrich the clinicians’ knowledge pertaining to chemotherapy-induced nail changes.

Relationship of cutaneous manifestations with inflammatory markers in diabetic nephropathic patients on haemodialysis

<p class="abstract"><strong>Background:</strong> Diabetic nephropathy is a serious life threatening complication of type-2 diabetes mellitus. Apart from severe kidney dysfunction these patients are prone to various cutaneous complications including psoriasis and eczema due to accumulated nitrogenous waste products. Inflammation is the basic cause of cutaneous complications and many inflammatory markers have been shown elevated in chronic kidney dysfunction. Hence a study has been planned to assess the levels of inflammatory markers such has C-reactive protein (CRP) and interlukin-6 (IL-6) as well as to correlate these markers with creatinine levels along with existing cutaneus complications.</p><p class="abstract"><strong>Methods:</strong> The study included 50 diabetic nephropathic patients undergoing regular heamodialysis. A heparanised blood sample was collected and plasma was employed for estimation of glucose, creatinine, CRP and IL-6. A detailed dermatological examination was done to record the cutaneous complications like pruritis, xerosis, hyper pigmentation and half & half nails.<strong></strong></p><p class="abstract"><strong>Results:</strong> The results show a significant raise in CRP and IL-6 levels in proportion to the severity of kidney dysfunction as reflected by creatinine levels. Also a positive relationship was observed between the inflammatory markers and multiplicity of cutaneous complications.</p><p class="abstract"><strong>Conclusions:</strong> It can be concluded from the present study that evaluation of inflammatory markers, CRP and IL-6 along with creatinine is beneficial in controlling cutanious complications in DN patients undergoing regular heamodialysis.</p>

Cutaneous Abnormalities in Chronic Kidney Disease Patients with and without Dialysis

Background: Chronic kidney disease (CKD) is increasingly prevalent worldwide. CKD may present with different cutaneous manifestations. Objectives: To evaluate the dermatological manifestations and compare these manifestations between patients with maintenance hemodialysis (MHD) and non-dialysis groups. Methods: It was a cross sectional study conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2013 to March 2014. A total of 150 hospital admitted CKD patients were evaluated for dermatological manifestations. Age, gender, haemoglobin level, 24-hours urinary total protein (UTP), serum creatinine, serum fasting lipid profile, estimated glomerular filtration rate (e-GFR) and dermatological manifestations of the study subjects were recorded accordingly. Inter-group comparisons were made between patients with and those without cutaneous abnormality. Results: Out of 150 study subjects, 99 (66%) were male and 51 (34%) were female, 69 (46%) patients were on MHD and 81 (54%) patients were without dialysis, their mean (±SD) age was 44.6 ± 12.3 year. A Total of 126 (84%) patients had cutaneous abnormalities; among them 69 (54.76%) were pre-dialytic and 57 (45.24%) were on MHD group. The mean (±SD) serum creatinine was relatively higher but haemoglobin level was significantly lower (p = 0.021), while UTP was significantly higher (p = 0.038) among patients with cutaneous abnormality. There was no relationship between lipid profile with cutaneous abnormality. Among 126 (84%) patients with cutaneous abnormality; pallor was the most common cutaneous abnormality (72%) followed by xerosis (68.66%), pruritus (65.33%), half and half nails (38.66%), pigmentation (33.33%), purpura/ecchymosis (16.66%), fungal infection (16%), ulcerative stomatitis (10.66%) and bacterial infection (10%). Pigmentation (52.6%), purpura (35.1%), ulcerative stomatitis (21.1%) and bacterial infection (19.3%) were significantly higher in MHD group. Among 69 (54.76%) predialytic patients; 11 (15.94%), 20 (28.98%) and 38 (55.07%) of them were on CKD stage-III, IV and V respectively. Conclusions: The dermatological disorders are frequent among CKD patients. Pallor, pruritus, xerosis, pigmentation and purpura are predominant changes. Pigmentation, purpura, ulcerative stomatitis and bacterial infection are significantly higher in MHD patients. Cutaneous abnormalities are more frequent in advance stages of CKD.

Study of cutaneous manifestations in chronic kidney disease patients on maintenance hemodialysis at a tertiary care centre

<p class="abstract"><strong>Background:</strong> Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years through five stages, presents with various cutaneous manifestations regardless of its aetiology. Patients of CKD disease on hemodialysis treatment which prolong the life expectancy and can also produce skin lesions. Skin changes described in patients with chronic renal disease are also found in patients with renal failure undergoing treatment with either peritoneal dialysis or hemodialysis. High percentage of patients receiving dialysis complains of pruritus that may be severe, in some instances the pruritus worsens with dialysis. The aims of the present study were to study the pattern of cutaneous lesions in patients with chronic kidney disease and to determine the incidence of skin manifestations specific to and associated with CKD.</p><p class="abstract"><strong>Methods:</strong> Hundred patients of CKD on MHD with cutaneous manifestations attending skin outpatient department, nephrology out-patient department, dialysis center and patients admitted in medical wards were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The common cutaneous manifestations were xerosis 91%, pallor 78% and pruritus 69%. Nail manifestations include onycholysis 37% and half and half nails 33%. Hair manifestations in 24% patients.</p><p class="abstract"><strong>Conclusions:</strong> Most common cutaneous manifestation was xerosis, followed by pallor. Most common nail manifestation was onyholysis.</p>

Skin manifestations in end stage renal disease patients on hemodialysis.

Chronic kidney disease (CKD) is a world public health problem that is related with high morbidity and mortality. CKD patients can present with different skin manifestations, often benign with much impact on quality of patients life. Study Design: Case-series study. Setting: Nephrology Unit Civil Hospital Larkana. Period: From 1st January 2018 to 30th June 2018. Material and methods: 141 patients of ESRD on regular HD for at least 1 month. Patients were chosen randomly for evaluation of cutaneous changes regardless of their gender, age, sex and etiology of ESRD. General and dermatological examination of the skin, hair, nails, and oral mucosa was performed by consultant dermatologist. Data were analyzed by using IBM SPSS version 23.0. Descriptive analyses performed using mean with standard deviation and median with inter quartile ranges of quantitative data set. Count and percentages were reported for categorical data set. Results: In the present study there were one hundred and forty one patients. Out of them skin manifestations of patients, 87.9% had Xerosis, 31.9% found with skin hyper pigmentation, 9.2% had Subungal Hyperkeratosis, 24.1% had Uremic Pruirtis, 45.4% had Pallor, and 6.4% found with Bruises. There were 9.9% cases of Alopecia, 17.7% cases of half n half nail, 1.4% cases of half n half nail with alopecia, 9.2% cases of Koilionychia, 0.7% cases of Koilionychia with alopecia, 2.8% found with koilonychias and half n half nail, 2.1% with leuconycia and koilionychia, 15.5% with Leuconychia, 2.1% found with Leuconychia and alopecia, and 0.7% found with Leuconychia, koilonychia & alopecia in Hair and Nail changes. Conclusion: The range of skin manifestations vary in different studies. Although often benign with much impact on quality of patient’s life and life can be threatening. Early treatment of skin disorders can improve the quality of life.

An Observational Study of Dermatological Manifestations in Patients of Chronic Renal Failure Undergoing Hemodialysis

Background: Chronic renal failure (CRF) 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 chronic renal failure (CRF) undergoing hemodialysis. Methods: ninty three .. patients with CRF on hemodialysis were examined for cutaneous changes. Results: all the patients complained of some skin problem. The most prevalent finding was xerosis (54.8%), followed by pallor (21.5%), pruritus (19.35%) and cutaneous pigmentation (18.3%). Other cutaneous manifestations included Kyrle's disease (5.4%); fungal (5.4%), bacterial (6.5%) and viral (3.2%) infections; purpura (9.7%). The nail changes included half and half nail (21%), koilonychia (39.78%), onychomycosis (1.08%), onychorrhexis (6.45%), splinter hemorrhages (1.08%), and Beau's lines (2%). Hair changes included sparse hair (18.28%), and brittle and lusterless hair (11.83%). Oral changes included macroglossia with teeth markings (23.65%), . Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were not observed. Conclusions: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.