Perforating Desease Of Hemo Dialysis

[2_DallasCowboys]

Hi,

I hope I am placing this in the right spot,  also hoping someone can
help me.

A very, very good friend of ours, who is on dialysis with my husband, Les,
has had very bad sores on one of her legs.  She also is diabetic.  The drs.
in our area said she had skin cancer-  she went to Sloan Kettering, the
major hospital in NYC for cancer.

The oncologist there said he did not believe it was skin cancer, but
Perforating Disease of Hemo D. which is very very rare but does occur
in dialysis patients.

Has anyone heard of this?  I tried a search on IHD but did not find anything.
If anyone can help me out with this a little I would so truly appreciate it.
Ruth is a terrific woman, and has been hit with so many different health issues
I do wonder how she bears it.

Again, anything on this would be so appreciated.

Thanks, Anne

[pelagia]

I found this on the web.  It's good that she does not have cancer, but it doesn't sound like there is a good treatment for this skin disorder. 

Nature Clinical Practice Nephrology (2009) 5, 157-170
doi:10.1038/ncpneph1040 
Received 9 July 2008 | Accepted 16 December 2008 | Published online: 3 February 2009

Skin problems in chronic kidney disease

Dirk RJ Kuypers 

ACQUIRED PERFORATING DERMATOSIS

Acquired perforating dermatitis (APD, also known as Kyrle disease) has a prevalence of approximately 10% in dialysis populations and occurs predominantly in African Americans and patients with diabetes mellitus. APD is also associated with other entities such as hepatic disease, thyroid illnesses, malignancies, scabies and AIDS. APD is usually characterized by a linear confluence of papules with a central, oystershell-like keratotic plug on the trunk, proximal extremities, scalp and face. Lesions are red or pink in white patients, and hyperpigmented in black patients. APD can initiate intense pruritus with secondary development of scratch marks (Koebner phenomenon). The origin of APD lesions is not known; suspected causes include an inflammatory skin reaction secondary to the presence of uremic toxins, uric acid deposits or scratching-induced trauma. Histological changes include the presence of epidermal invaginations with a central, basophilic, keratotic plug, uric acid and calcium hydroxyapatite deposits and chronic inflammatory granulomas.

Treatment of APD is often frustrating as lesions can persist and chronic scars can develop. Lubricants, steroids, keratolytics, vitamin A, cryotherapy, UVB therapy and oral or topical isotretinoin preparations have all been tried with variable degrees of success.

http://www.nature.com/nrneph/journal/v5/n3/full/ncpneph1040.html

[2_DallasCowboys]

Thank you so much for the info!

Anne