A Clinical Study of the Cutaneous Manifestations of Chronic Renal Failure.

Dhanalakshmi, K (2006) A Clinical Study of the Cutaneous Manifestations of Chronic Renal Failure. Masters thesis, Madras Medical College, Chennai.

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Abstract

The kidney and the skin are the two large networks of the body with their abundant blood supply, far in excess of their nutritional demands, the former for the constancy of the milieu interior and the latter maintaining mainly homeostasis. No wonder therefore, that they share many diseases and reflect mutually one another’s pathology which should be made use of by the clinician. Scientific and technologic improvements during the second-half of the 20th century have provided renal replacement therapy as a life-sustaining option for many individuals who otherwise may have died. For each year of the last 10 years, the number of individuals with end stage renal disease has grown approximately 20,000 per year. Cutaneous examination of patients with end stage renal disease has shown that 50 – 100% of the patients have at least one dermatologic condition. In addition to end stage renal disease, Uremia and conditions associated with replacement therapy are fraught with numerous and, often relatively unique cutaneous disorders. AIMS : 1. To study the various cutaneous manifestations and their incidence in patients with chronic renal failure. 2. To study the age and sex incidence of the individual cutaneous manifestations. 3. To study the incidence and types of cutaneous infections in chronic renal failure. 4. To study the treatment-related (medical and dialysis) dermatologic manifestations of chronic renal failure. 5. To correlate between the skin manifestations of systemic disorders with chronic renal failure. CONCLUSION: This clinical study of cutaneous manifestations of chronic renal failure was done during the period December ’03 to December ‘05 revealed the following 1. Most of the specific cutaneous manifestations of chronic renal failure were seen in this study. Pruritus and xerosis were the most common among the specific cutaneous manifestations of chronic renal failure. Pigmentary alterations and nail abnormalities were the next. Mucosal and hair abnormalities were noted in good percentage of cases. Nearly 10% had perforating dermatosis and purpura. Interesting findings noted in this study were digital gangrene, poor wound healing, and restless leg syndrome. 2. Skin changes due to treatment reported were arteriovenous shunt dermatitis, keratotic pits of palms in small percentage and blue nails in a patient during hemodialysis, other than pruritus and pigmentary alterations. 3. Cutaneous infections and infestations were seen in 43.8 % of the cases. This high incidence could be due to impaired immunity resulting in increased susceptibility to infections in chronic renal failure patients. Fungal infections were the most common, followed by viral, bacterial and parasitic infestations. 4. Associated skin changes of systemic diseases helped in finding varying etiologies of chronic renal failure such s diabetes mellitus, systemic lupus erythematosus, scleroderma, vasculitis, Henoch schonlein purpura, idiopathic thrombocytopenic purpura. A case of cortical medullary disease in Ellis van creveld syndrome was reported with cutaneous changes. A case of tuberous sclerosis with renal involvement and skin changes was seen. Other associated skin changes were not related to the etiology and were found to be just coincidental.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cutaneous Manifestations ; Chronic Renal Failure ; Clinical Study.
Subjects: MEDICAL > Dermatology Venereology & Leprosy
Depositing User: Subramani R
Date Deposited: 05 Jul 2017 00:42
Last Modified: 05 Jul 2017 08:13
URI: http://repository-tnmgrmu.ac.in/id/eprint/930

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