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Renal Exam
 
 

Skin Inspection

 
 
 
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Rashes Associated with Renal Disease

Xerosis cutis: abnormally dry skinCold weather, excessive bathing, irritants, advanced age, uraemia, diabetes, hypothyroidism
Livedo reticularis: mottled, lace-like lesions, commonly on the legsBenign, cholesterol emboli, calciphylaxis, cryoglobulinaemia, anticardiolipin syndrome, SLE, rheumatoid arthritis, malignancy
Porphyria cutanea tarda: blisters over sun-exposed areas such as the scalp, dorsal hands and forearms, neck and face.Uraemia, liver disease
Kyrle's disease: hyperpigmented papules with a central keratin plug.Chronic kidney disease, diabetes, liver failure
Prurigo nodularis: firm, crusty, pruritic papules and nodules with a symmetrical distribution.CKD, Hepatitis C, HIV, H pylori, lymphoproliferative disorders
Calciphylaxis (calcific uraemic arteriopathy): mottled skin progressing to painful subcutaneous plaques / nodules that eventually form necrotic ulcersRare complication of CKD, especially dialysis patients

Hyperpigmentation

  • Look For

  • Areas of hyperpigmented skin.
  • Causes of Hyperpigmentation

  • Dermatoses - ephelides (freckles), melanocytosis
  • Post-inflammatory - sunlight exposure (tan), dermatitis, infection, trauma
  • Haemochromatosis
  • Alcoholic liver disease
  • Cirrhosis
  • Renal failure
  • Cutaneous amyloidosis
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