A nephrologist from Greater Taichung yesterday urged people experiencing itchy skin to seek medical advice after a 60-year-old man who overlooked the symptom was later diagnosed with severe uremia — kidney failure — and will now require a lifetime of dialysis treatments.
According to the nephrologist at Cheng Ching General Hospital’s Jhong Gang Branch who treated the patient, Lai Chien-pin (賴建賓), the man had originally attributed his skin irritation to his work as an environmental volunteer, which constantly put him in contact with waste and insects.
However, as the temperature dropped in recent weeks, the patient’s skin disorder started worsening and he developed large bumps called papules with hollow centers that bled and scabbed over after being scratched.
After a period of observation of the patient’s skin conditions, Lai concluded that the man had contracted acquired perforating dermatosis (APD), a perforating skin disorder commonly found in patients with kidney diseases.
“APD is one of the more obvious symptoms of kidney diseases, but people who are diagnosed with the skin disorder could already be in a severe stage of uremia,” Lai said, adding that APD is also prevalent in patients with end-stage renal diseases or diabetes.
Lai said that by the time the man visited his outpatient service, the APD had spread to his limbs, abdomen and neck, and his blood sample revealed 12mg per deciliter of creatinine, which indicates renal function, which is eight times the normal level.
A renal ultrasound confirmed that the man’s kidneys had started shrinking and were not functioning properly, Lai said, adding that he would need dialysis three times a week.