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 CKD
for 3 month to 5 years were studied for mucocutaneous manifestations. Forty (30.7%) patients were on
hemodialysis for 1-3 months. Detailed medical history, clinical and mucocutaneous examination and lab
investigations were performed. KOH mounts, skin biopsy, Gram’s and Giemsa staining, bacterial or fungal
cultures were performed as required.
Results: Xerosis in 104 patients (80%), skin pallor in 76(58.4%), pruritus in 52 (50.9%) patients, pigmentation
in 45(34.6%) and purpura in 12 (9.2%) patients were the major dermatoses. Perforating folliculitis occurred
in1 (0.76%) patient..Mucosal findings included coated tongue in14(11.66%), xerostomia in 11(9.16%) and
macroglossia 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 included
sparse 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 in
29(22.3%), leuconychia in 13(10%), onycholysis in 9(6.9%), Beau’s lines in 6(4.6%), koilonychias in
4(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 common
mucocutaneous manifestations in the studied patients irrespective of hemodialysis status.