Cutaneous Manifestations of Chronic Renal Failure in Children of Color

Abstract

One hundred percent of adult patients with chronic renal failure (CRF) develop cutaneous findings as a result of uremia or due to therapeutic interventions. To date, pediatric incidence studies have been limited to Caucasian children. However, recent reports have indicated that more African American patients progress to end-stage renal disease (ESRD). This is the first study to assess the prevalence of renal failure-related skin disease in children of color, including African American and Hispanic patients. Thirty children were evaluated by history and physical examination, with assignment to one of three treatment categories: transplanted (n = 10), dialyzed (n = 16), or medically managed (n = 4). Skin findings were divided into uremic, drug-related, or infectious disease types. The incidence of skin disease was 100%. Xerosis was the single most common finding, often accompanied by pruritus. Cushinoid features were common despite the addition of steroid-sparing agents. Cyclosporin A-treated African American children had a high incidence of gingival hypertrophy (72%) and an even higher incidence of hypertrichosis (100%). Acral warts and nevi were common findings, the latter correlating with the length of immunosuppression. There is a high incidence of cosmetically disfiguring side effects (Cushinoid facies, hypertrichosis, and gingival hypertrophy) in children within all treatment categories, primarily related to drug treatment. Further study is required to determine the long-term sequelae, including psychological disturbances, of cutaneous disease in children of color with CRF.

Pattern of skin and nail changes in chronic renal failure in Nepal: A hospital‐based study

“…Silverberg et al . have reported xerosis to be more common in kidney transplant recipients and patients on dialysis, 5 however, in this study there was no significant difference in the frequency of xerosis in dialysis and non‐dialysis patients.…”

Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis

“…Silverberg et al 7 reported infectious cutaenous lesions in 70% of their patients with CRF, the most common being verrucae vulgaris, pityriasis versicolor, folliculitis and herpes zoster. In this study only 2 (4%) had infectious cutaneous lesions, one had pityriasis versicolor with folliculitis and other had herpes simplex labialis, which was lower than seen in other studies .…”

Diseases of cutaneous appendages

“…1181,1182 There may be rapid resolution after treatment of the malignancy. 1171,1185,1186 Minoxidil-induced hypertrichosis may be limited to the face. Vellus hairs, intermediate forms, and terminal hairs may also be increased in paraneoplastic cases, 1176 as well as in cases of porphyria, malnutrition and brain injury and, usually reversibly, in patients taking streptomycin, phenytoin (diphenylhydantoin), corticosteroids, penicillamine, psoralens, benoxaprofen, the vasodilators diazoxide and minoxidil, 1184 and cyclosporin A (cyclosporine).…”