Dr. Ganapathy Raja Kasirajan

CKD is not just a kidney problem — sometimes it shows up on the skin too. One such clue is Acquired Perforating Dermatosis (APD), a stubborn, intensely itchy skin condition seen more often in chronic kidney disease, diabetes, and dialysis patients. What does it look like?Small to large itchy bumps or nodules with a central crust/plug, often over the arms, legs, back, and trunk.Scratching makes it worse — and new lesions can appear because of Koebner phenomenon. Why does it matter?Because this is often mistaken for:eczema, fungal infection, allergy, or simple pruritus — and treatment keeps getting delayed. The real message:✅ control CKD-related itch✅ optimize dialysis✅ manage phosphate and diabetes✅ moisturize the skin well✅ treat inflammation early✅ consider dermatology review and biopsy when needed Treatment options may include:✅ topical steroids and antihistamines for itch relief✅ keratolytic agents or retinoids in selected cases✅ phototherapy for resistant disease✅ better glycemic and renal control to reduce recurrence For patients: don’t ignore persistent itching in CKD. Final verdict : look beyond “just pruritus.” Skin can reveal uremia. May 23, 2026