Bullous Disease of Dialysis Treatment & Management

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

Any photosensitizing drug that the patient may be using should be identified and, if possible, discontinued.

Sunlight avoidance, application of topical sunscreen formulations blocking long ultraviolet and visible light, and protection of exposed skin from mechanical trauma may help to reduce severity of lesions. Intermittent treatment of secondarily infected bullae or erosions with topical or systemic antibiotics may be required.

Dialyzed patients are at risk for oxidative stress due to deficiency of several antioxidant enzymes, including glutathione peroxidase and glutathione reductase. [17]  Oral administration of N-acetylcysteine or glutamine to several patients, as an approach to glutathione repletion, was considered beneficial in all but one case (see Medication).