Renal diseases skin changesjeweilige Hauterkrankung

There are essentially three nephrological patient groups for whom the dermatologist is a sought-after partner in the treatment of their skin problems.

• Patients with chronic terminal renal insufficiency (frequently dialysis patients).
• Patients with kidney transplants
• Patients with systemic vasculitis and renal involvement.

• Chronic renal failure (N18.9) and uremia (N19): see below. Renal failure, skin les ions
• Renal transplantation:
  • The dermatological problem in kidney transplant patients does not differ significantly from that of other organ transplant patients and is therefore not "organ-specific". It is based on the permanent immunosuppression and its consequences for the organism.
• Diabetic nephropathy:
  • Elastosis perforans serpiginosa
  • Folliculitis perforans
  • Hyperkeratosis follicularis et parafollicularis in cutem penetrans (M. Kyrle)
  • perforating collagenosis occurs almost exclusively in patients with diabetic nephropathy (see below renal insufficiency, skin lesions).
• Renal tumors:
  • Skin metastases in renal carcinoma occur in 5% of cases and are monitorable in 1%.
• Acute or chronic nephritides in the context of infectious, vasculitic, rheumatic or metabolism-induced diseases.
  • Not infrequently, systemic diseases such as vasculitides, infections, metabolic diseases, rheumatic diseases occur, in which skin diseases are associated with renal affections in varying frequency. Different variants are possible:
    • Triggering of skin symptomatology by nephrogenic disease, renal carcinoma [skin metastasis].
    • bacterial nephritis [triggering of Reiter's disease]
    • bacterial skin disease and consecutive bacterial nephritis, vasculitides simultaneously affecting skin and kidney (e.g., Purpura Schönlein-Henoch).
• Other skin diseases associated with acute or chronic renal disease:
  • AA-type amyloidosis (chronic glomerulonephritis)
  • Coproporphyria hereditaria (interstitial nephritis)
  • Dermatomyositis (acute nephritic syndrome)
  • Dermatosis, acute febrile neutrophilic (nephritis)
  • Ecthyma (acute poststreptococcal glomerulonephritis is possible)
  • erysipelas (infectious glomerulonephritis is possible, especially in the elderly)
  • Gout (interstitial nephritis, nephrolithiasis)
  • Impetigo contagiosa, small blistered (acute poststreptococcal glomerulonephritis is possible)
  • Cat scratch disease (glomerulonephritis)
  • Cryofibrinogenemia (glomerulonephritis)
  • Lipodystrophy, progressive partial (proliferative glomerulonephritis)
  • Lupus erythematosus, systemic (acute nephritic syndrome)
  • Fabry disease (development of progressive renal failure)
  • Foot and mouth disease (nephritis)
  • Nail-patella syndrome (non-specific glomerulonecrosis)
  • Onycholysis
  • Polyarteritis nodosa, microscopic (glomerulonephritis)
  • Polyarteritis nodosa, systemic (glomerulonephritis)
  • Purpura abdominalis (haemorrhagic nephritis)
  • Purpura Schönlein-Henoch (IgA nephropathy: 30-90%)
  • Reiter's syndrome (bacterial pyelonephritis)
  • Rheumatic fever (glomerulonephritis)
  • Scarlet fever (acute poststreptococcal glomerulonephritis)
  • Sjögren's syndrome (interstitial nephritis)
  • Scleroderma, systemic (acute nephritic syndrome)
  • Syphilis acquisita (nephritis)
  • Urticaria of the serum type (nephritis)
  • Varicella (nephritis)
  • Vasculitis in essential cryoglobulinemia (glomerulonephritis)
  • Vasculitis, hepatitis C-associated (glomerulonephritis)
  • Wegener's granulomatosis (glomerulonephritis)
  • Weil, M. (nephritis).

1. Chan IH et al (2016) Itch Management: Physical Approaches (UV Phototherapy, Acupuncture). Curr Probl Dermatol 50:54-63.
2. Kremer AE et al (2016) Pruritus in systemic diseases: Common and rare etiologies. Dermatologist 67:606-614.