Frequency of Skin Lesions in Haemodialysis Patients in Four Iranian Hospitals (Case Report) (Clinical Report‪)‬

Introduction Chronic renal failure (CRF) is defined as irreversible dysfunction of the kidney and makes the patient dependent on dialysis or kidney transplantation [1]. Metabolic and endocrine functions normally performed by the kidney will be impaired and this may result in anaemia, malnutrition, problems in the metabolism of carbohydrates, fat and protein, incomplete consumption of energy, and metabolic bone diseases. Raised plasma levels of many polypeptide hormones including parathormone (PTH) are considered uraemic poisons [1]. Dermatological symptoms of kidney failure are only detected in advanced cases of the disease and therefore are not valuable in diagnosis of kidney failure [2]. Complete and precise examination of the skin, hair, nails, and mucosal membranes may reflect many of the following symptoms [1]. The skin colour may be pale due to anaemia or pale yellow due to the precipitation of chromium. Skin hyper-pigmentation may be due to an increase of melanocyte-stimulating hormone (MSH) in sun-exposed areas that results in melanin precipitation in basal and superficial epidermal layers. Extended ecchymosis is due to the problems in platelet aggregation and other haemostatic dysfunctions. Weak skin turgor is due to the CRF dehydration [1]. Generalised severe itching is seen in about one-third of cases with CRF [2]. Calcified panniculitis, perforating skin disorders, bullous dermatoses and nail problems are also detected in CRF.