ABSTRACT
Intensity and spatial distribution of pruritus varies significantly over time and patients are affected to a varying intensity throughout the duration of their renal disease. The intensity of UP ranges from sporadic discomfort to complete restlessness during daytime and nighttime. Initially, patients with uremic pruritus do not show any changes in skin appearance. As secondary phenomena, excoriation by scratching with or without impetigo can occur and, rarely, prurigo nodularis can be observed. (Fig. I a-d). There are interindividual differences in spatial distribution of UP: 25-50% of the affected patients complain about generalized pruritus (6,7). In the remaining patients, UP seems to affect predominantly the back, the face, and the shunt
Figure 1 Skin affects observed in patients with uremic pruritus: (a) scratches on the arm hosting the fistula; (b) deep scars on the shoulders and the back of a female patient on hemodialysis; (c) prurigo nodularis with excoreations and superinfection on the forearm of a patient on peritoneal dialysis; (d) Kyrle's disease on the back of a patient on hemodialysis.
