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Pruritus and Hemodialysis. Presented by Dr. A. W. Young, Jr.
A 52-year-old white man has been treated by hemodialysis a total of 179 times at a rate of two or three times weekly for about two years because of end-stage renal failure (pyelonephritis). Additional history includes hypertension, congestive heart failure, peptic ulcer with episodes of bleeding, cardiovascular accident, and pulmonary tuberculosis. His pruritus began coincidentally with hemodialysis and is more or less constant with paroxysmal flares, which occur perhaps on the day preceding treatment, but not during hemodialysis. Dermatologic history disclosed no disorders, except contact dermatitis due to chrome. His drug intake consists of vitamins, folic acid, Basogel, ferrous gluconate, chloral hydrate, and digitalis.Examination revealed the skin to be moderately xerotic with numerous hyperkeratotic prurigo-like papules. The nail folds were flattened and the nails were white.Laboratory findings prior to hemodialysis included values for the following: glucose, 100 to
Atkinson SC. NEW YORK DERMATOLOGICAL SOCIETY. Arch Dermatol. 1974;109(1):107. doi:10.1001/archderm.1974.01630010075036