In addition to general skin changes like pallor or dryness and the frequent, often excruciating nephrogenic pruritus, specific diseases in patients with renal failure may occur. Acquired perforating dermatoses are usually also highly pruritic. Calciphylaxis is a severe disease with poor prognosis. Nonhealing wounds with superinfection and progression to sepsis are characteristic. Bullous lesions can be caused by disturbances in porphyrin metabolism. Nephrogenic systemic fibrosis is a disease which was first described in 2000. Its incidence is already on the decline. Furthermore, this article provides an overview of systemic diseases which have both skin symptoms and kidney changes. These include connective tissue diseases, vasculitis or sarcoidosis and amyloidosis. After a kidney transplantation, particular attention must be paid to the development of skin tumors and infections. The last part of this article is dedicated to genodermatoses with skin and renal involvement, where numerous causative mutations have already been characterized. Knowing the correlations of characteristic skin symptoms and specific, potentially life-threatening kidney disease is important in order to initiate further investigations and steps such as referral to nephrologists at an early stage.
Urticaria, defined by the presence of wheals and/or angioedema, is a common skin disorder, but the etiology of urticaria in children remains incompletely understood. The aim of this study is to determine the clinical characteristics of urticaria in children. We retrospectively investigated 73 patients (range 0-14 years, female 40 patients) who suffered from urticaria and visited to our outpatient clinic more than twice from 2010 to 2013. Data were collected regarding age, sex, disease duration, severity and laboratory parameters such as total IgE, antinuclear antibodies and routine laboratory tests. From 73 patients with urticaria, there were 45 patients (61.6%) with spontaneous acute urticaria and 13 patients (17.8%) with spontaneous chronic urticaria. Mean disease duration at first visit of chronic urticaria was 5.0 months. Among the patients with spontaneous acute urticaria, infection was found as the trigger in 17 patients (37.8%). And there were 8 patients (11.0%) with allergic urticaria (food or drug), 5 patients (6.6%) with physical urticaria (solar, cold contact or heat contact), 2 patients (2.6%) with angioedema and 2 patients (2.6%) with mastocytosis. Our data showed that spontaneous acute urticaria was the most frequent type of urticaria, followed by spontaneous chronic urticaria. In addition, infections were the most frequent triggering factor of acute urticaria.
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