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<p class="abstract"><strong>Background:</strong> The number of patients with end-stage renal disease (ESRD) in India is increasing with an estimated annual incidence of about 100 per million populations. Hemodialysis is one of the therapeutic modalities which can improve the survival in these patients. About 50–100% of patients with ESRD have at least one associated cutaneous change Skin problems are common and diverse in patients with chronic kidney disease (CKD), especially among those on hemodialysis. Objective was<strong> </strong>to study dermatologic manifestations among patients with chronic kidney disease on maintenance hemodialysis.</p><p class="abstract"><strong>Methods:</strong> A descriptive observational study was conducted in 77 consecutive chronic kidney disease patients receiving maintenance hemodialysis for more than 3 months at Manik Hospital, Aurangabad, Maharashtra, India.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 77 patients, 51 (66.23) of males and 26 (23.67) of females were examined. Male: Female ratio was 1.96: 1. The mean age was 51.17±15.22 years. Seventy three (94.08) patients had at-least one skin manifestation. Xerosis was the commonest manifestation (87.01), followed by pruritus (57.14). Cutaneous infections were noted in 55.84% patients. Fungal infections were more common with 27.27%. Mild xerosis was noted in 55.84% patients, 24.67% patients were moderate and whereas severe xerosis was noted in 6.49% patients.</p><p class="abstract"><strong>Conclusions:</strong> Chronic kidney disease patients have prolonged life expectancy due to hemodialysis, hence they should be looked for presence of various skin manifestations which can affect the usual work and cause sleep disturbance which adds to the morbidity and mortality.</p>

Background: Diabetes mellitus is a fairly common medical disorder that involves almost every specialty in its spectrum of clinical manifestation, and up to 1/3 rd of patients with diabetes mellitus are estimated to have cutaneous changes. In other words using broadest criteria all subjects with diabetes will diabetes will develop cutaneous manifestations of this disease. Methods: A total of 100 diabetic patients with cutaneous manifestations, who attended skin OPD at Civil Hospital, Belgaum, Karnataka, India and K.L.E'S Hospital and Medical Research Centre, were randomly selected. The present study was conducted over a period of 22 months from March 1995 to December 1996. Total 100 cases were included in this study. The male to female ratio is 1.6:1 approximately. Detailed history, physical examination, cutaneous and mucous membrane involvement examination was done. Diabetes Mellitus was confirmed by urine sugar and blood sugar estimation. The diagnosis of diabetes mellitus was done on the basis of criteria laid down by national diabetic data group. Urine and blood sugar estimation was done in all the cases. Results: Fungal infections were common cutaneous manifestation followed by bacterial infections and generalized pruritus. Those patients who were on oral hypoglycaemic drugs, insulin therapy found to have photodermatitis and localized lipoatrophy. The common associated skin diseases with diabetes mellitus were fungal infection (38%) and viral infections (2%). Unexplained generalized pruritus was observed in (17%) cases, followed by pruritus ani is (3%) and prurigo simplex in (1%). Cutaneous markers of diabetes i.e acrochordons were observed in 17% cases. The other manifestations observed were lichen planus (6%), PLE (3%), psoriasis (3%), vitiligo (2%), Kyrles disease (2%), infected eczema (2%), scabies (2%), lichen simplex chronicus (2%) and pemphigus vulgaris (1%). Conclusions:The physicians should be aware of cutaneous manifestations in diabetes mellitus. Where the ignorance of skin manifestations in diabetes or improper treatment may makes the condition worse. The early detection and early treatment of common skin manifestations in diabetes will prevent further complications or ineffectiveness due to treatment especially in cases of carbuncle, extensive tinea corporis, psoriasis, lichen planus, macro and micro angiopathies, trohic ulcers etc. A well-controlled diabetes by drugs, diet and exercise will allow the patient to lead a normal life like any other normal individuals.

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