Skin Inspection
November 28th, 2019
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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