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Cutaneous Manifestations of Renal Disease

Cutaneous Manifestations of Renal Disease. Stephanie Blackburn OMS IV OU-HCOM. Types of Skin Changes. Cutaneous manifestation of renal failure- the skin changes that nearly all renal patient have Systemic diseases with prominent renal and cutaneous manifestations ( eg . HSP)

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Cutaneous Manifestations of Renal Disease

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  1. Cutaneous Manifestations of Renal Disease Stephanie Blackburn OMS IV OU-HCOM

  2. Types of Skin Changes • Cutaneous manifestation of renal failure- the skin changes that nearly all renal patient have • Systemic diseases with prominent renal and cutaneous manifestations (eg. HSP) • Diseases that affect the kidney in which skin biopsy may be helpful in making the diagnosis, even without prominent cutaneous findings (eg. Primary systemic amyloidosis)

  3. Chronic Renal Failure

  4. Uremic Frost • Classic manifestation of chronic renal failure. Whitish deposits about the face and neck. Hypothesized to be due to deposition of crystallized urea from sweat.

  5. What are half-and-half nails? • Proximal half of nail is white and distal portion retains the normal pink color. Thought to be due to edema of nail bed.

  6. Muehrcke’s Nails • Associated with hypoalbuminemia and have two transverse parallel white bands, separated from each other and from the lunula by areas of normal pink nail

  7. Acquired Perforating Dermatosis of Chronic Renal Failure • Kyrle’sdisease • Abnormal clone of keratinocytes that perforates through the epidermis down into the dermis • Reactive perforating collagenosis • Disease in which presumably abnormal collagen is being extruded from the dermis through the epidermis • Perforating folliculitis • Follicular plugs and curled-up hairs that perforate through the follicle into the dermis • Calcinosis Cutis • Deposition of insoluble calcium in the skin

  8. Kyrle’s Disease

  9. Reactive Perforating Collagenosis

  10. Perforating Folliculitis

  11. Calcinosis Cutis

  12. Five vasculitic diseases that frequently affect skin and kidneys • Leukocytoclasticvasculitis • Henoch-Schӧnlein purpura • Polyarteritis nodosa • Microscopic polyarteritis: p-ANCA • Wegener’s granulomatosis: c-ANCA

  13. NephrogenicFibrosingDermopathy • Nephrogenic systemic fibrosis- thickened or edematous skin that primarily affects the extremities and trunk • Nephrogenic systemic fibrosis always occurs in patients with renal insufficiency who have had imaging studies (eg, magnetic resonance angiography) with gadolinium • In severe cases there may be restriction of movement or disabling contracture of the joints • Increased numbers of fibroblasts and mucin in early lesions with marked fibrosis in later lesions.

  14. Nephrogenicfibrosingdermopathy on the abdomen, demonstrating a peaud'orange appearance

  15. References • Dermatology Secrets in Color- Third Edition James E. Fitzpatrick, Joseph G. Morelli • dermatlas

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