Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jul 6, 2016; 5(4): 372-377
Published online Jul 6, 2016. doi: 10.5527/wjn.v5.i4.372
Skin disorders in peritoneal dialysis patients: An underdiagnosed subject
Meltem Gursu, Sami Uzun, Derya Topcuoğlu, Leyli Kadriye Koc, Lamiye Yucel, Abdullah Sumnu, Egemen Cebeci, Oktay Ozkan, Ahmet Behlul, Leyla Koc, Savas Ozturk, Rumeyza Kazancioglu
Meltem Gursu, Lamiye Yucel, Rumeyza Kazancioglu, Department of Nephrology, Bezmialem Vakif University Medical Faculty, 34093 Istanbul, Turkey
Sami Uzun, Derya Topcuoğlu, Abdullah Sumnu, Egemen Cebeci, Oktay Ozkan, Ahmet Behlul, Leyla Koc, Savas Ozturk, Department of Nephrology, Haseki Training and Research Hospital, 34093 Istanbul, Turkey
Leyli Kadriye Koc, Department of Dermatology, Haseki Training and Research Hospital, 34093 Istanbul, Turkey
Author contributions: All the authors contribute to the manuscript.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Meltem Gursu, Associate Professor, Department of Nephrology, Bezmialem Vakif University Medical Faculty, Adnan Adivar Bulvari, Vatan Street, Fatih, 34093 Istanbul, Turkey. meltem1401@yahoo.com
Telephone: +90-505-2953371 Fax: +90-212-5294463
Received: January 12, 2016
Peer-review started: January 15, 2016
First decision: February 2, 2016
Revised: March 2, 2016
Accepted: April 21, 2016
Article in press: April 22, 2016
Published online: July 6, 2016
Processing time: 169 Days and 1.4 Hours
Abstract

AIM: To examine all skin changes in peritoneal dialysis (PD) patients followed up in our unit.

METHODS: Patients on PD program for at least three months without any known chronic skin disease were included in the study. Patients with already diagnosed skin disease, those who have systemic diseases that may cause skin lesions, patients with malignancies and those who did not give informed consent were excluded from the study. All patients were examined by the same predetermined dermatologist with all findings recorded. The demographic, clinical and laboratory data including measures of dialysis adequacy of patients were recorded also. Statistical Package for Social Sciences (SPSS) for Windows 16.0 standard version was used for statistical analysis.

RESULTS: Among the patients followed up in our PD unit, those without exclusion criteria who gave informed consent, 38 patients were included in the study with male/female ratio and mean age of 26/12 and 50.3 ± 13.7 years, respectively. The duration of CKD was 7.86 ± 4.16 years and the mean PD duration was 47.1 ± 29.6 mo. Primary kidney disease was diabetic nephropathy in 11, nephrosclerosis in six, uropathologies in four, chronic glomerulonephritis in three, chronic pyelonephritis in three, autosomal dominant polycystic kidney disease in three patients while cause was unknown in eight patients. All patients except for one patient had at least one skin lesion. Loss of lunula, onychomycosis and tinea pedis are the most frequent skin disorders recorded in the study group. Diabetic patients had tinea pedis more frequently (P = 0.045). No relationship of skin findings was detected with primary renal diseases, comorbidities and medications that the patients were using.

CONCLUSION: Skin abnormalities are common in in PD patients. The most frequent skin pathologies are onychomycosis and tinea pedis which must not be overlooked.

Keywords: Skin; Peritoneal dialysis; Onychomycosis; Tinea pedis; Xeroderma

Core tip: Skin abnormalities are common in peritoneal dialysis patients. We aimed in our study to examine all skin changes in peritoneal dialysis patients followed up in our unit. Among the 38 patients included, all but one patient had at least one skin lesion. Loss of lunula, onychomycosis and tinea pedis are the most frequent skin disorders recorded in the study group. Diabetic patients had tinea pedis more frequently. No relationship of skin findings was detected with primary renal diseases, comorbidities and medications that the patients were using. Skin changes are commonly overlooked and should be sought for timely diagnosis and treatment.