Bullous dermatosis of chronic renal failure

Four of five patients with chronic renal failure developed tense bullae on the backs of their hands and fingers. In one of these patients the bullae were more widespread. In the fifth patient the lesions were limited to the fingers. The clinical picture resembled that of porphyria cutanea tarda, but porphyrin studies were consistently within normal limits. Histological studies showed subepidermal pressure bullae in each patient. In one of the patients immunohistology showed greenish fluorescence at the bases of the dermal papillae.