DIAGNOSTIC CHALLENGES IN HEMODIALYSIS PATIENTS
Diagnosis of Common Dermopathies in Dialysis Patients: A Review and Update
Version of Record online: 19 JUL 2012
© 2012 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 25, Issue 4, pages 408–418, July/August 2012
How to Cite
Markova, A., Lester, J., Wang, J. and Robinson-Bostom, L. (2012), Diagnosis of Common Dermopathies in Dialysis Patients: A Review and Update. Seminars in Dialysis, 25: 408–418. doi: 10.1111/j.1525-139X.2012.01109.x
- Issue online: 19 JUL 2012
- Version of Record online: 19 JUL 2012
Cutaneous abnormalities in patients with end-stage renal disease (ESRD) receiving hemodialysis or peritoneal dialysis may demonstrate signs of their underlying condition or reveal associated disease entities. While a thorough examination of the scalp, skin, mucosa, and nails is integral to establishing a diagnosis, certain conditions will resolve only with dialysis or improvement of their renal disease and others may not require or respond to treatment. Half and half nails, pruritus, xerosis, and cutaneous hyperpigmentation are common manifestations in ESRD. With hemodialysis, uremic frost is no longer prevalent in ESRD patients and ecchymoses have decreased in incidence. Acquired perforating dermatoses are seen in over one-tenth of hemodialysis patients. Metastatic calcinosis cutis and calciphylaxis are both rarely reported, although the latter is seen almost exclusively in the setting of hemodialysis. Diagnosis of nephrogenic systemic fibrosis has historically been challenging; as such, new diagnostic criteria have been proposed. Blood porphyrin profiles are needed to differentiate between porphyria cutanea tarda and pseudoporphyria. We will review and provide an update on the aforementioned common cutaneous manifestations of ESRD in patients receiving dialysis.