CUTANEOUS MANIFESTATION IN CHRONIC KIDNEY DISEASE PATIENTS UNDER HAEMODIALYSIS

Background- This study aimed to evaluate and analyze the patternof cutaneous manifestations in CKD patients under hemodialysis. Methodology- The present study was conducted as a prospective observational study at Department of Medicine, Hamidia Hospital, Bhopal for a period of 2 years on 100 patients with CKD on maintenance hemodialysis. A detailed history was taken and a complete dermatological examination was performed.Digital photograph of skin lesions were taken and all the patients were then subjected to relevant investigation. Viral marker was performed when clinically indicated. Mean age of patients was 40.85±14.58 years and Results- majority of patients were males (70%). Mean duration of hemodialysis was 1.59±1.50 years. Most common cutaneous manifestations in patients with CKD was xerosis (26%) followed by pruritis (12%), eczema (12%) and scabies (8%). Other less common cutaneous manifestations. Cutaneous manifestations are Conclusioncommon in patients with CKD. Among various manifestations, most common cutaneous manifestations of CKD were xerosis, pruritis, eczema and scabies. Prophylactic preventive measures can reduce the adverse effects of cutaneous symptoms. Early recognition of cutaneous manifestations in CRF can improve outcome and reduce patient sufferings.

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Scalp shagreen patch: an unusual cutaneous manifestation of tuberous sclerosis complex: a case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172495 ◽

2017 ◽

Vol 5 (6) ◽

pp. 2815

Author(s):

Abdullah Abualiat ◽

Wifag Elobeid ◽

Hala Edris

Keyword(s):

Tuberous Sclerosis ◽

Tuberous Sclerosis Complex ◽

Skin Lesions ◽

Lumbosacral Region ◽

Cutaneous Manifestations ◽

Variable Expression ◽

Dermatological Examination ◽

Multisystem Involvement ◽

History Of ◽

Clonic Seizures

Tuberous sclerosis complex (TSC) is an inherited neurocutaneous disorder with multisystem involvement and highly variable expression of the disease. Common cutaneous manifestations include angiofibromas, periungual fibroma, ash-leaf-shaped macules and shagreen patch which is slightly elevated soft skin-coloured plaque usually found in lumbosacral region. We report a case of TSC in a 21- year- old Saudi man with a 13 years history of asymptomatic skin lesions and generalized tonic-clonic seizures. Dermatological examination revealed facial angiofibromas, ash leaf macules, pedunculated fibromas on trunk, and shagreen patch on the back. Scalp swelling was found and confirmed to be shagreen patch by the histopathology findings. In conclusion, scalp shagreen patch is an unusual presentation of TSC. It should be considered in clinical examination of suspected cases of TSC with relevant histopathology to confirm the lesion.

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Dermatological Manifestation in Coronavirus Disease 2019 Patients in Iraq

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7095 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1085-1091

Author(s):

Anfal L. Al-Harbawi ◽

Qasim S. Al Chalabi ◽

Hala N. Alsalman ◽

Mohammad S. Saeed

Keyword(s):

Early Recognition ◽

Cutaneous Lesion ◽

Maculopapular Rash ◽

Skin Lesions ◽

Cross Sectional Study ◽

Prodromal Phase ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

High Incidence ◽

Common Skin

Background: Coronavirus disease-19 (COVID-19) is a growing pandemic around the globe that was initially discovered in Wuhan in December 2019. Despite the relatively high incidence of cutaneous manifestations in COVID-19, their role in early recognition and disease progression has not been fully investigated. Aim of this study: To report the possible incidence of the cutaneous lesion in COVID 19 patients and to describe various cutaneous manifestations and their correlation with other clinical features in Covid-19 positive patients to facilitate diagnosis and prognostications toward this virus. Methods: This research was conducted as a cross-sectional study. Skin lesions photography and their analysis were collected by dermatologists from 18 cities in Iraq between September 2020 to January 2021. The data were processed using statistical package SPSS version 23. Results: A total of 3117 confirmed COVID-19 cases were included in this study. Around 268 patients developed skin lesions with age ranged between 8 to 84 years. Of these skin lesions, 46.2% developed during the illness with minority erupting during the prodromal phase, whilst 38.8% appeared after hospitalization. The most common skin lesion was in the form of urticarial 36.74% followed by herpetic lesions 28.4%, maculopapular rash 11.74% and the remainder being candidiasis, oral thrush, chilblains, and other skin conditions. The most affected area was the torso (46%) followed by limbs, face, fingers, and toes. Conclusion: This study demonstrated the high incidence rate of dermatological lesions in different phases of COVID-19 with urticarial rash being the most frequent clinical pattern.

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A clinical study of cutaneous manifestations in neonates at a tertiary health care center

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20213340 ◽

2021 ◽

Vol 7 (5) ◽

pp. 658

Author(s):

M. Sneha ◽

Kumaravel Sadagopan ◽

Vaishnavi D.

Keyword(s):

Care Center ◽

Skin Lesions ◽

Normal Variants ◽

Cutaneous Manifestations ◽

Detailed History ◽

Vernix Caseosa ◽

Health Care Center ◽

Mongolian Spot ◽

History Of ◽

Neonatal Skin

Background: Cutaneous alterations are commonly seen in neonates as a normal process of adaptation to the external air environment after birth. It is good to know about transient skin lesions in infants to distinguish them from other conditions that prevent unwanted neonate therapy. Parents should be confident of the excellent prognosis of these manifestations of the skin. The aim of the study was to determine the patterns of cutaneous manifestations occurring among the newborn.Methods: This prospective study was conducted in the newborn with at-least one cutaneous manifestation. A detailed history of the neonates and mother was collected using pre-designed proforma.Results: Of 100 neonates, 52 were males, 48 were females, of these, 85 were born at term, 10 were preterm, and 5 were post-term. Mongolian spot was seen in lumbosacral, buttocks and extremities in 80 (80%) neonates, vernix caseosa in 20 (20%) neonates. Milia in 14 (14%) neonates, eczematous eruption in 30 (12.5%).Conclusions: This neonatal skin research has provided details on normal variants occurs during the neonatal phase. It is necessary to know that most newborn skin lesions are temporary and do not require any treatment.

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Cutaneous manifestations in chronic renal failure patients on hemodialysis and medical management

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20170432 ◽

2017 ◽

Vol 3 (1) ◽

pp. 24 ◽

Cited By ~ 1

Author(s):

Senthil Asokan ◽

Murali Narasimhan ◽

Rajagopalan V.

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Medical Management ◽

Skin Lesions ◽

Cutaneous Manifestations ◽

Cutaneous Infections ◽

Dermatological Examination ◽

Duration Of Disease ◽

Skin Biopsies ◽

Complete Blood Counts

Background: Over the past few decades, the developments in the field of Nephrology have improved the life expectancy of patients with chronic kidney disease (CKD). This situation provides more time for the dermatological conditions to manifest. The objective of the present study was to evaluate the different clinical patterns of cutaneous manifestations in chronic kidney disease and also to compare the cutaneous manifestations in CKD patients on dialysis and medical management.Methods:. 120 consecutive cases of chronic kidney disease were included in the study. This included inpatients and outpatients, patients on medical management as well as those undergoing hemodialysis. A detailed history was taken and complete dermatological examination was performed. Digital photographs of skin lesions were taken. Relevant investigations like complete blood counts, blood urea, serum creatinine, serum electrolytes were performed routinely. Special investigations like KOH mount for fungus, Tzanck smear and skin biopsies were performed when clinically indicated.Results: The number of cutaneous manifestations present in each patient is compared based on severity and duration of CKD. 82.8% of patients with severe CKD had more than one dermatoses compared to 60% of patients with mild CKD. So, multiple cutaneous manifestations could be found in the same patient, as the severity of CKD increases. Xerosis and hyperpigmentation were more prevalent in patients undergoing dialysis than those on medical management alone.Conclusion: In patients with CKD xerosis, pruritus, pigmentation, nail changes and cutaneous infections were the predominant cutaneous manifestations. The prevalence of xerosis and hyperpigmentation were higher in patients with longer duration of disease and increased as the severity of CKD increased. The prevalence of pruritus was independent of the duration and severity of CKD.

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The clinical significance of cutaneous metastasis and paraneoplastic skin lesions in ovarian cancer. A rare but not minor manifestation

Hellenic Journal of Obstetrics and Gynecology ◽

10.33574/hjog.1503 ◽

2018 ◽

Vol 17 (1) ◽

pp. 13-18

Author(s):

Nikolaos Machairiotis ◽

Nikolaos Thomakos ◽

Anastasios Malakasis ◽

Alexandros Rodolakis

Keyword(s):

Ovarian Cancer ◽

Early Recognition ◽

Skin Lesions ◽

Cutaneous Metastasis ◽

Clinical Findings ◽

The Body ◽

Cutaneous Manifestations ◽

Ovarian Cells ◽

Abnormal Cells ◽

High Index Of Suspicion

Ovarian cancer results in the formation and proliferation of abnormal cells that have the ability to proliferate faster than normal/typical ovarian cells and then spread to other parts of the body either in a local or in a systemic way. The areas to which the metastases of ovarian cancer can be located include the lining of the abdomen, lining of the bowel and bladder, lymph nodes, lungs, liver and in very rare cases the skin. We performed a review of the literature in order to find and document the cutaneous manifestations of the different types of ovarian cancer. Skin is a rather unusual organ for the localization of metastatic ovarian cancer but it must not be overseen. Cutaneous metastasis from carcinoma are relatively uncommon in clinical practice but they are very important to recognize. Cutaneous metastasis may herald the diagnosis of internal malignancy, and early recognition can lead to accurate and prompt diagnosis and timely treatment. However, a high index of suspicion is required because the clinical findings may be subtle. Our understanding of skin disease remains mainly descriptive rather than pathophysiologic. The variation and the multipotent skin expression of the ovarian as well as other intrabdominal, supradiaphragmatic malignancies reveal their similarity to autoimmune diseases, leading to the inert question if it is immunologic modulated.

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Study of cutaneous manifestations in chronic kidney disease patients on maintenance hemodialysis at a tertiary care centre

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20194666 ◽

2019 ◽

Vol 5 (4) ◽

pp. 771

Author(s):

Kirankanth Vudayana ◽

Vidyasagar Korla ◽

Dilipchandra Chintada ◽

Jami Vijaya Shree

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Chronic Renal Disease ◽

Tertiary Care ◽

Skin Lesions ◽

Maintenance Hemodialysis ◽

Tertiary Care Centre ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Medical Wards

Background: Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years through five stages, presents with various cutaneous manifestations regardless of its aetiology. Patients of CKD disease on hemodialysis treatment which prolong the life expectancy and can also produce skin lesions. Skin changes described in patients with chronic renal disease are also found in patients with renal failure undergoing treatment with either peritoneal dialysis or hemodialysis. High percentage of patients receiving dialysis complains of pruritus that may be severe, in some instances the pruritus worsens with dialysis. The aims of the present study were to study the pattern of cutaneous lesions in patients with chronic kidney disease and to determine the incidence of skin manifestations specific to and associated with CKD.Methods: Hundred patients of CKD on MHD with cutaneous manifestations attending skin outpatient department, nephrology out-patient department, dialysis center and patients admitted in medical wards were included in the study.Results: The common cutaneous manifestations were xerosis 91%, pallor 78% and pruritus 69%. Nail manifestations include onycholysis 37% and half and half nails 33%. Hair manifestations in 24% patients.Conclusions: Most common cutaneous manifestation was xerosis, followed by pallor. Most common nail manifestation was onyholysis.

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Eye Tumors in Childhood as First Sign of Tumor Predisposition Syndromes: Insights from an Observational Study Conducted in Germany and Austria

Cancers ◽

10.3390/cancers13081876 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1876

Author(s):

Madlen Reschke ◽

Eva Biewald ◽

Leo Bronstein ◽

Ines B. Brecht ◽

Sabine Dittner-Moormann ◽

...

Keyword(s):

Optic Nerve ◽

Observational Study ◽

Ciliary Body ◽

Prospective Observational Study ◽

Genetic Data ◽

Detailed History ◽

Cancer Early Detection ◽

Physical Examinations ◽

Eye Tumors ◽

Multicenter Prospective Observational Study

Retinoblastoma and other eye tumors in childhood are rare diseases. Many eye tumors are the first signs of a genetic tumor predisposition syndrome and the affected children carry a higher risk of developing other cancers later in life. Clinical and genetic data of all children with eye tumors diagnosed between 2013–2018 in Germany and Austria were collected in a multicenter prospective observational study. In five years, 300 children were recruited into the study: 287 with retinoblastoma, 7 uveal melanoma, 3 ciliary body medulloepithelioma, 2 retinal astrocytoma, 1 meningioma of the optic nerve extending into the eye. Heritable retinoblastoma was diagnosed in 44% of children with retinoblastoma. One child with meningioma of the optic nerve extending into the eye was diagnosed with neurofibromatosis 2. No pathogenic constitutional variant in DICER1 was detected in a child with medulloepithelioma while two children did not receive genetic analysis. Because of the known association with tumor predisposition syndromes, genetic counseling should be offered to all children with eye tumors. Children with a genetic predisposition to cancer should receive a tailored surveillance including detailed history, physical examinations and, if indicated, imaging to screen for other cancer. Early detection of cancers may reduce mortality.

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Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

SAGE Open Medical Case Reports ◽

10.1177/2050313x21997194 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2199719

Author(s):

Juan Carlos Palomo-Pérez ◽

Maria Elisa Vega-Memije ◽

David Aguilar-Blancas ◽

Erik González-Martínez ◽

Lucia Rangel-Gamboa

Keyword(s):

Respiratory Symptoms ◽

Case Series ◽

Signs And Symptoms ◽

Skin Lesions ◽

World Health ◽

Medical Community ◽

Atypical Pneumonia ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

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Reexpansion pulmonary edema

Jornal de Pneumologia ◽

10.1590/s0102-35862003000200010 ◽

2003 ◽

Vol 29 (2) ◽

pp. 101-106 ◽

Cited By ~ 11

Author(s):

Eduardo Henrique Genofre ◽

Francisco S. Vargas ◽

Lisete R. Teixeira ◽

Marcelo Alexandre Costa Vaz ◽

Evaldo Marchi

Keyword(s):

Pulmonary Edema ◽

Pulmonary Surfactant ◽

Preventive Measures ◽

Early Recognition ◽

Patient Handling ◽

Prompt Treatment ◽

Treatment And Prevention ◽

Inflammatory Status ◽

Reexpansion Pulmonary Edema ◽

Practical Recommendations

Reexpansion pulmonary edema (RPE) is a rare, but frequently lethal, clinical condition. The precise pathophysiologic abnormalities associated with this disorder are still unknown, though decreased pulmonary surfactant levels and a pro-inflammatory status are putative mechanisms. Early diagnosis is crucial, since prognosis depends on early recognition and prompt treatment. Considering the high mortality rates related to RPE, preventive measures are still the best available strategy for patient handling. This review provides a brief overview of the pathophysiology, diagnosis, treatment, and prevention of RPE, with practical recommendations for adequate intervention.

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Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191592 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1007

Author(s):

Vijoy S. Kairi ◽

Pinaki Chakravarty ◽

Arun Kumar Sipani

Keyword(s):

Prospective Observational Study ◽

Tertiary Care Hospital ◽

Early Recognition ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Case Record ◽

Medical College ◽

Disease Modifying ◽

Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

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