Cutaneous and mucosal manifestations in patients on maintenance hemodialysis: a study of 101 patients in Sari, Iran

Abstract

Introduction: Cutaneous and mucosal disorders are of the common problems in patients on long-term hemodialysis. The aim of this study was to evaluate the frequency of dermatologic problems among patients with end-stage renal disease (ESRD) who receive maintenance hemodialysis.

Materials and methods: One hundred and one patients with ESRD on hemodialysis were studied. All of patients were fully examined for cutaneous, nail, hair, and mucosal changes by a single dermatologist. Complementary diagnostic measures such as biopsy of the lesions were carried out, where necessary.

Results: The patients were 43 (42.6%) women and 58 (57.4%) men with a mean age of 50.0 +/- 12.3 years. The duration of hemodialysis was 36.0 +/- 11.0 months. Dermatologic examination revealed that 95 patients (94.1%) suffered from cutaneous problems. Skin discoloration (66.3%) was the most common skin lesion. Pruritus was seen in 38.6% of the patients. Hair, mucous membrane, and nail problems were present in 37.6%, 23.8%, and 43.6% of the patients, respectively. There was a significant association of the number of cutaneous manifestations with the age of the patients (P = .001), but not with hemodialysis duration. The most common hair disorder was hair loss in 9.9% of the patients and the most common oral mucosal problem was furred tongue (7.9%). Of the nail disorders, nail bed paleness (16.8%) was the most common.

Conclusions: Cutaneous and mucosal lesions in patients with ESRD can vary from each patient population to another. Factors such as diagnostic accuracy, climate, and early treatment influence some disorders such as pruritus, xerosis, and infections.