Clinical Pattern of Dermatoses in Patients with Chronic Kidney Disease in Ile-Ife, Nigeria

Abstract

Background: Dermatoses are common in patients with chronic kidney disease (CKD). These dermatoses vary from the more common xerosis, pruritus, hyperpigmentations, to the less common manifestations such as nephrogenic systemic fibrosis, bullous dermatosis of haemodialysis. They arise as a consequence of failure of excretory or endocrine functions. Iatrogenic causes may also contribute to the development of these dermatoses. These manifestations impact greatly on the quality of life of patients with CKD by increasing the morbidity and rarely the mortality. Objective: The objective of this study was to determine the pattern of dermatoses among patients with CKD in Ile-Ife. Materials and Methods: The study was a cross sectional study involving patients with CKD attending Obafemi Awolowo University Teaching Hospitals Complex, (OAUTHC) Ile-Ife. One hundred and twenty patients recruited for the study had relevant clinical evaluation to confirm the dermatoses and to determine the stage of CKD. Data were analysed using SPSS version 16. Results: The subjects aged between 18 and 84 years with a mean age of 50.76 (±18.6) years. Seventy six (63.3%) males and forty four (36.7%) females participated in the study. The occurrence of dermatoses was observed in the study to be 57.5%. The observed dermatoses did not vary significantly with stage of CKD (p=0.780). Xerosis was the commonest dermatoses observed in 26.7% of patients. Other dermatoses observed in these patients included, pruritus(13.3%), hyperpigmentation(12.5%). Pallor together with ‘half and half’ nails accounted for 10.8% each.Fungal infections and icthyosis also constituted 6.7% each.  Plantar hyperkeratosis, follicular hyperkeratosis, chronic leg ulcer,arteriolar shunt dermatitis, alopecia, bacterial infections and Mee’s lines were also documented. Conclusion: This study shows a high prevalence of dermatosis (57.5%) among CKD patients. The observed prevalence was comparatively lower than the previously reported prevalence for this environment presumably due to improving access to better care.