[Skin manifestations in patients with renal chronic renal failure on regular hemodyalysis]

The authors studied the skin disorders in 50 hemodialyzed patients. Pruritus appears to be the main dermatological feature by the frequency of its occurrence and by its unpleasant and even intolerable effects. This sign is more frequent among long time dialyzed patients and seems to be due to 2 factors: high urea blood concentration and secondary hyperparathyroidism. Calcinosis cutis is less frequent than pruritus. It seems to have the same origin and can be considered in the more general picture of the metastatic calcinosis in patients with renal failure and secondary hyperparathyroidism. Hypermelanosis, exceptional in the chronic renal insufficiency patients before hemodialysis, is present in 41% of our group. It is more obvious in the long time dialyzed patients. The nail disorders are mostly the absence of lunula (30%), related to the anaemia, and the half and half nail (36%) that seems specific of the severe azotaemia. Skin dryness (30%) and ichthyosis (10%) can be related to the pruritus. Alopecia, drug reactions and prurigo seems to have a particular indidence. Two patients presented bullous eruptions localized in sunlight exposed areas of skin. The clinical, histological and immunological aspect was identical to that observed in the Porphyria Cutanea Tarda but all the porphyrin levels in the urine and faeces were normal.