MEDICINA INTERNA CECIL 25 EDICAO PDF DOWNLOAD SKINHowever, on examination, all patients had atleast one skin lesion attributable to ESRD. Results: Eighty-two per cent patients complained of some dermatologic problem. Methods: One hundred patients with ESRD on hemodialysis were examined for cutaneous changes. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with End Stage Renal Disease (ESRD) undergoing hemodialysis. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. With an almost 100% prevalence in CKD, early recognition of these skin manifestations and prompt initiation of treatment can dramatically alter their course and even detect underlying renal disease.īackground: End Stage Renal Disease(ESRD) presents with an array of cutaneous manifestations. Black pigmentation of the tongue, not usually seen was observed in 41% of patients. There was also a remarkable increase in the diversity of skin changes that correspond with severity of CKD (p=0.044). There was a significant decrease in pruritus(p=0.034) and an increase in pallor(p=0.001) in dialysis patients compared to others. Other changes seen were striae, purpurae, ecchymoses, Kyrle’s disease, pyodermas, mucosal, hair and nail changes and other infections. The common skin changes observed were xerosis (75%), hyperpigmentation (56%), pruritus (48%). Creatinine clearance was calculated for staging of CKD. 75 patients on CKD, including patients on hemodialysis, were examined for cutaneous changes. This study was undertaken to study the variety and prevalence of cutaneous manifestations in chronic renal disease, and their correlation with severity of CKD, and also to correlate variations in cutaneous changes with hemodialysis. Prognosis is not directly related to the nail changes, commonly to the severity of the underlying disorders.Ĭhronic Kidney Disease (CKD) is associated with various cutaneous abnormalities caused either by the disease or by treatment and can precede or follow initiation of dialysis, significantly impairing the quality of life in individuals. Conclusions: Clubbing in cardio respiratory system, half and half nail (HHN) in renal system and terry's nail in liver and GIT are the specific nail changes that can lead us to the diagnosis. Clubbing was the commonest nail change encountered (34.67%) followed by longitudinal ridging (29.33%), pallor of nail plate (28%), platyonychia (18.67%) and brittle nails (17.33%). Most commonly involved systems include respiratory system (23.4%) followed by haematopoietic (18%), GIT and liver (14%), renal (12%) and cardiovascular system (10%). Results: Nail changes were common with inpatients (58.7%) compared to outpatients (41.3%) and in 5.4% patients it was incidental. Investigations were done according to the system involvement. Nails were examined for their appearance, colour, contour, lunula, nail folds. With informed consent, detailed history and clinical examination done including general physical examination and cutaneous examination. Materials and Methods: One hundred and fifty patients attending the outpatient and inpatients from the hospital were included. To correlate nail changes with prognosis. To assess the specificity of the nail changes with the disease status. Objectives of the study: To evaluate the prevalence of the nail changes in systemic diseases. This study will enlighten the importance of the nail changes associated with systemic diseases. In spite of this knowledge, there has been relatively little attention paid to the nails. Background: Many systemic disorders leave their mark on the nails and, therefore, provide physicians with valuable clues to diagnosis.
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