Bullous Disease of Dialysis Clinical Presentation

Updated: Dec 26, 2019
  • Author: Amira M Elbendary, MBBCh, MSc; Chief Editor: William D James, MD  more...
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Presentation

History and Physical Examination

History

Individuals with chronic renal failure who are afflicted with bullous disease of dialysis typically develop these lesions only after months to years of maintenance dialysis regimens. The lesions are more florid after sunlight exposure. However, patients often are unaware of the role of sunlight in evoking the lesions, since they do not note discomfort in the skin during the exposure.

Physical examination

Vesicles and bullae filled with clear or hemorrhagic fluid and exudative erosions occur chiefly on the dorsal hands, although the scalp, face, and neck also may be affected. Blistering limited to volar fingertips was observed in one case. [11] Healing of crusted erosions leaves atrophic scars. Milia, dyspigmentation, and hypertrichosis occur infrequently.