zohreh haj heydari

Spironolactone (SPN), which is classified as an anti-androgen, has demonstrated efficacy in treating acne. This study aimed to utilize ultrasonication to create a chitosan-coated nano lipid carrier (NLC) for enhancing the delivery of SPN to the skin and treating acne.

Various hydrophilic-lipophilic balance (HLB) values were investigated to optimize the SPN-NLCs. Photon correlation spectroscopy, attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), transmission electron microscopy (TEM), and differential scanning calorimetry (DSC) were employed to characterize the solid state of SPN in nanoparticle form. Additionally, the optimized formulation was used in a double-blind, randomized clinical trial.

Reducing the HLB of the surfactant mixtures resulted in a reduction in the size of SPNNLCs. The formula with the smallest particle diameter (238.4±0.74 nm) and the lowest HLB value (9.65) exhibited the highest encapsulation efficiency (EE) of 79.88±1.807%. Coating the optimized SPN-NLC with chitosan increased the diameter, polydispersity index (PDI), zeta potential (ZP), and EE. In vitro skin absorption studies demonstrated sustained release profiles for chitosan-coated SPN-NLC. In the double-blind trial, a gel containing chitosan-coated SPN-NLC effectively treated mild to moderate acne vulgaris, leading to improved healing and reduced lesion count after 8 weeks of therapy compared to the placebo. It successfully addressed both non-inflammatory and inflammatory lesions without adverse effects on the skin.

The findings indicate that chitosan-coated SPN-NLCs have the potential as nanoparticles for targeted SPN delivery to the skin, offering novel options for the treatment of acne vulgaris.

Background and

Seborrheic dermatitis (SD) is a chronic skin condition that is accompanied by scaling and itching. Stress and mental rumination followed by the disease affect the quality of life. The aim of this study was to investigate the effect of seborrheic dermatitis on the quality of life and to compare it with the quality of life of healthy people.

This study was a cross-sectional study. The study sample included 60 randomly selected patients with seborrheic dermatitis who referred to Bouali and Tooba dermatology clinics in Sari during 2019-2020. Two questionnaires (DLQI and SF-36) were used to assess general quality of life in patients.

The relationship between the disease and occupation was statistically significant. There was a significant relationship between smoking and seborrheic dermatitis. We also found a significant relationship between the frequency of recurrences and quality of life. The mean of physical and social function in the healthy group was higher than its value for the patient group, but the difference was not significant.

Our study showed that age, education, occupation, and smoking are factors that contribute to seborrheic dermatitis. Moreover, the findings revealed that physical and mental health as well as quality of life were less affected in the married group compared to the single group.

Psoriasis is a systemically pathogenic immune-mediated, chronic inflammatory disease that mostly affects the skin. Ocular diseases, which are frequently nonspecific or just slightly bothersome in psoriasis, are not well-known. This study investigated ocular manifestations in patients with psoriasis.

This cross-sectional study was conducted at Bu-Ali Sina hospital in Sari, Iran. Seventy-five patients with psoriasis matched by age and sex with 75 non-psoriatic controls were examined. Dermatology life quality index (DLQI) and psoriasis area and severity index (PASI) scores were calculated for every patient with psoriasis. Ocular surface disease index (OSDI) was measured in both groups. We did a slit-lamp examination, Schirmer I test, tear breakup time (TBUT) and fundoscopy in both groups.

The mean age of patients was 40.11±13.88 years. The most common findings on our examinations were conjunctival hyperemia (38%), blepharitis (36%), MGD (33%), and pinguecula (26%). MGD and low TBUT were more common in patients with higher PASI and DLQI scores. OSDI score was also higher in patients with psoriasis.

Ocular surface conditions such as dry eye were more common among the participants and were correlated with duration and severity of the disease. Therefore, psoriasis patients should get frequent and routine eye exams to detect ocular disorders quicly and avoid their unintended effects.

Cryotherapy, which causes inflammation, is one of the methods used in treatment of warts. Including a topical steroid in a regular wound care regimen slows the course of damage and promotes re-epithelialization. The purpose of this study was to assess the therapeutic efficacy of topical betamethasone valerate on inflammation after cryotherapy in patients with warts compared to placebo.

Twenty people were included in a double blind clinical trial. Cryotherapy was used on both sides of the body to treat the lesions. Following cryotherapy, topical betamethasone was applied to the lesions on one side, while placebo ointment was applied to the lesions on the opposite side. The patient's symptoms were documented during four visits. To assess pain intensity, the visual pain scale (VAS) was used. Finally, treatment evaluation was scored during these four sessions. SPSS V16 was used to analyze the data.

None of the samples at the end of the study had hypertrophic or atrophic scars and depigmentation, hyperpigmentation or hypopigmentation lesions. Mean erythema, pain, frequency of blistering and frequency of edema during 14 days of follow-up were not significantly different between the two groups (P>0.05).

During the 14-day follow-up period after therapy, topical betamethasone had no effect on the incidence of blisters and edema, as well as the average score of pain and erythema. As a result, this treatment modality cannot be used to relieve inflammation following cryotherapy in patients with warts.

Among different clinical entities of dermatophytosis, tinea capitis (TC) is considered a major public health challenge in the world, especially in regions with poor health and low income. Therefore, this study aimed to provide a retrospective analysis of the patients suspected of TC who were referred to the medical mycology laboratory of Mazandaran, a northern province of Iran.

A retrospective analysis was performed on the patients suspected of TC who were referred to the medical mycology laboratory from July 2009 to April 2022. Hair roots and skin scrapings were collected from the participants. The laboratory diagnosis was confirmed by direct microscopic examination and culture. Finally, 921 out of 11095 (8.3%) patients were suspected of TC.

Based on the findings, TC was confirmed in 209 out of 921 patients (22.7%). In terms of gender, 209 TC patients (75.1%) were male. Moreover, the male to female ratio of TC patients was 1:3.0. Trichophyton tonsurans (146/174, 83.91%) was the most etiological agent,followed by T. mentagrophytes (13/174, 7.47%), T. violaceum (9/174, 5.17%), Microsporum canis (3/174, 1.71%), T. verrucosum (2/174, 1.15%) and T. rubrum (1/174, 0.57%). Besides, endothrix (77.0%) was the most prevalent type of hair invasion.

The results revealed the predominance of T. tonsurans, as a causative agent of TC. Despite the prevalence of TC, the absence of appropriate consideration highlights that it is a neglected complication among children.

Psoriasis is one of the most common skin diseases. For the first time in Iran, we conducted a case-control study to evaluate bone mineral density in patients with psoriasis vulgaris in comparison with a healthy control group (20 individuals in each group). Our study sample included patients referred to the dermatology clinic of Razi Hospital in Ghaemshahr, Iran, between May and October 2019. Densitometry was performed by the DEXA method on the 2nd to 4th lumbar vertebrae and hip bone. Patients’ demographic information and Psoriasis Area Severity Index (PASI) scores were recorded and analyzed using SPSS version 22.

The mean T-score in the case and control groups were -0.47 ± 1.04 and -0.19 ± 0.45, respectively (P = 0.274). The mean T-score had a significant inverse correlation with an age of 40 years or above (r = -0.873 and P < 0.001), disease duration of more than five years (r = -0.599, P = 0.05), and PASI score (r = -0.523, P = 0.001), but had a positive correlation with sunlight exposure (r = 0.581, P < 0.001).

Considering the decrease in bone density in patients with psoriasis and its relationship with the disease severity and duration and the effectiveness of sunlight in increasing bone density, preventive treatment should be provided for all patients to increase bone density and prevent osteoporosis.

Acne vulgaris is a skin condition in children and has various presentations and differential diagnoses. 

The purpose of this review was to evaluate the therapeutic approaches of infantile acne.

In this narrative review, we searched articles published in English on infantile acne in Google Scholar, PubMed, and Scopus from 1981 to 2019. 

A total of 35 articles were selected for review. The treatment of acne often involves various medications that acne lesions. Different factors contribute to the pathogenesis of acne and its severity. The same principle and treatment strategy applies to all age groups diagnosed with acne.

The treatment strategy for infantile acne is similar to acne treatment at any age. Treatment is based on the severity of the acne and the risk of a future scar.

Eosinophilic fasciitis presents as painful symmetrical stiffness and limb sclerosis with deep fascia inflammation. Unilateral conflict has been rarely reported. In this paper, a young man with unilateral thigh and leg involvement is presented who developed symptoms following strenuous exercise. Clinical, laboratory, imaging, and pathology findings are discussed. Treatment with prednisolone and methotrexate was started.

Context: 

Warts are benign cutaneous and mucosal growths caused by human papillomavirus. Warts are the most common skin diseases seen by pediatric dermatologists. Warts are often self-limited, especially in children, but some lesions are not resolved despite repeated treatments and referred to as recalcitrant warts.

Evidence acquisition: 

Electronic databases such as Google Scholar, PubMed, and Scopus were searched during 2000-2018 and a review was conducted for articles published in English on pediatric warts by focusing on recalcitrant warts.

If warts are asymptomatic and being in a location that causes no cosmetic or other problems, observation is the ideal management course. Most parents and children prefer treatment for their warts. There are three modalities of treatment: medical, surgical, and immunotherapy.

Treatment of warts is a therapeutic challenge that depends on the patient’s age and the type of warts. Despite treatment according to evidence-based guidelines, a significant proportion of warts are failed to respond. This condition is an unsolved problem in practice. The management for treating these lesions has remained unclear and a wide range of the second line of treatments has been developed.

Seborrheic dermatitis is a common chronic relapsing inflammatory skin disease with unknown etiology. Using zinc and selenium supplements have shown some relieving effects on the symptoms of the disease. The present study was conducted to determine the relationship between serum selenium, zinc, and copper levels with seborrheic dermatitis. A prospective case-control study was performed on 30 patients with seborrheic dermatitis and 30 age and sex-matched healthy volunteers as a control group. Trace elements were measured by atomic absorption spectrophotometer in both groups. The mean serum selenium, zinc, and copper levels were 98.90 ± 27.61 ?g/dL, 91.27 ± 10.84 ?g/dL, and 100.9 ± 20.06 ?g/ dL in case groups, respectively. In the control group, the mean serum selenium, zinc, and copper levels were 91.61 ± 15.74 ?g/dL, 94.03 ± 11.11 ?g/dL, and 96.5 ± 15.82 ?g/dL, respectively. There was no significant difference between the mean serum selenium, zinc, and copper levels in case and control groups (P>0.05). Although no statistically significant relationship was observed in serum selenium, zinc, and copper levels between the cases and controls, the serum selenium level among patients in case group was higher than that in the healthy subjects.

Pediculus capitis, commonly known head lice, is prevalent among children. It caused by Pediculus humanus capitis. Although P.humanus capitis is not a vector of human disease, but infestation with head lice, is a frequent community health concern and can cause social distress. Incidence is rising related to increased resistance due to inadequate and unnecessary treatments. This review article can be used as a reference to common types of treatments in pediculosis. Treatments of Pediculosis capitis were searched in available online resources and databases such as PubMed, Science Direct, and Google Scholar, SID with Persian and English keywords including pediculosis, head lice, treatment, therapy and drugs during 1990 to 2018. The available treatment options for Pediculosis capitis include permethrin, Malathion, topical and oral ivermectin, benzyl alcohol, spinosad, dimethicone and mechanical remove of head lice and nits. Any of these treatments should be selected according to age and special conditions. It should be noted that the safest and most effective treatment selected for the patient and topical drugs are preferred as first line treatment. The use of systemic drugs should be limited to cases where there is no response or resistance to topical drugs. Screening and treatment of all close contacts will be helpful for adequate management of pediculosis.

Context: Scabies is a common infestation in children. Treatment of scabies in infants and children is a therapeutic challenge. Many prescribed drugs for adults cannot be used in children because of their side effects and safety profile. This review article studied the treatment of scabies in children and infants. Evidence Acquisition: In this review, electronic databases, including Google Scholar, PubMed, Cochrane and Scopus were searched based on the following MeSH terms: Scabies, Pediatric and Children. We included all articles related to scabies in children published from 2008 to 2018. Duplicated and irrelevant studies and abstracts were excluded. The management of scabies is focused on identification and treatment of cases and household contacts. We briefly discussed the clinical presentation of scabies with the currently used topical and oral treatments for this infestation. Topical treatments are effective and the most effective treatment is permethrin. Other treatment options may be less effective, poorly tolerated, or with adverse effects. Scabies is prevalent in children and causes considerable morbidity. Because of its complications, scabies should be managed properly in accordance with the guidelines.

Background and purpose: Due to the properties of Stevia, it seems that this plant can be effective in reducing oxidative damage consequent to ischemia-reperfusion, and increase the survival of skin flap. This research aimed at investigating the effects of oral extract of stevia on apoptosis and skin flap necrosis in rats. In this experimental study, Sprague Dawley rats were orally gavaged 25 mg/kg/daily of stevia leaf extract for one week, before or after the removal of flap. One week after surgery, the amount of flap necrosis, the content of malondialdehyde (MDA) in flap tissue, and superoxide dismutase (SOD) activity were measured. Pre-treatment or post-treatment with stevia leaf extract reduced the necrotic area in the flap compared to the control group. It also reduced the MDA content and increased SOD activity. Pre-treatment with stevia leaf extract was found to have a better protective effect than post-treatment in all variables investigated. Current findings confirmed the survival of the flap with oral administration of stevia leaf extract. The beneficial effects of oral extract of stevia leaf can be clinically examined in reducing ischemic flap necrosis before and after surgery.

Uremic pruritus is a common and distressing symptom that affects more than 40% of patients undergoing hemodialysis. Several medications as well as topical preparation have been used for relief this condition. Sambucus ebulus has been shown anti-inflammatory and wound healing effects. In this research, the antipruritic effect of S. ebulus fruit extract was evaluated on patients with uremic pruritus. S. ebulus fruits were collected from Sari suburb, Iran. Fruits were dried at room temperature and several fractions of extract were prepared. After formulating suitable gel (2%) a randomized, single blind, placebo-controlled clinical trial was performed in 78 patients (40 patients received S. ebulus topical gel 2% and 38 patients received placebo gel) for 8 weeks and the changes in hyperuremic induced pruritus severity were evaluated. Sixty one patients completed the study. The Pruritus severity index was reduced in both groups after 8 weeks’ treatment. S. ebulus topical gel showed more effect than placebo, but this difference was not statistically significant. The results showed that S. ebulus topical gel can reduce uremic pruritus severity, and more study with higher extract concentration or more cases is proposed.

Psoriasis is an inherited chronic inflammatory papulosquamous disorder with a variable clinical spectrum affecting about 0.5% to 2% of children and adolescence. In spite of all performed researches around the world for seeking better treatments with fewer adverse effects to control the disease, there is still no cure for psoriasis. Treatment of psoriasis in children is very conservative and many therapies used for adults may not be appropriate for children due to possible long-term or delayed adverse effects. A wide range of therapeutic options are existed including; topical therapy, phototherapy, chemotherapy, systemic therapies and biologic therapies. Here in, because of the lack of data in this specific field of dermatology, we decided to review the current therapies of childhood psoriasis.

Background and Scabies is caused by a mite called Sarcoptes scabiei and can be spread from person to person through skin contact. In this study, we have analyzed the effect of Malathion lotion 0.5% and compared that with the effect of Permethrin cream 0.5%. In a randomized clinical trial 60 patients were divided into two groups to receive either Permethrin cream 5% or Malathion lotion 0.5%. Both groups were monitored every two weeks for one month. The qualitative data of both groups were compared using student t-test and chi-square test was applied to analyze the qualitative data. There was no significant difference between the two groups in number of lesions at the begging of the study (P=0.1503). Also, no significant difference was seen in weeks two and four. But Malathion lotion was found to be more efficient than Permethrin (P=0.0163) in reducing the number of lesions; although the results were better in week four, but the difference was not significant (P=0.2940). This study showed high efficacy of Malathion 5% in treating scabies.

Psoriasis is a common chronic and recurrent inflammatory skin disorder characterized by hyperproliferation of keratinocytes and infiltration of T cells, monocytes/macrophages and neutrophils into dermal and epidermal layers of the skin. The prevalence of cardiovascular disorders in these patients is remarkably higher compared to normal individuals, which seems to be associated with the hyperlipidemia. This study was designed and conducted to investigate the serum lipid profile in psoriatic patients and its association with the severity of disease. MATHERIALS AND This case-control study was performed on 50 plaque-type psoriasis patients and 50 healthy individuals as control, matched for age and sex. Blood samples were collected after 14 h fasting. Serum triglyceride, cholesterol and lipoproteins were assayed using the standard kit (made by Pars Azmon Co. Iran). Certain parameters, including serum triglyceride, cholesterol, low density lipoprotein (LDL), and very low density lipoprotein (VLDL), were significantly higher in the case group compared to the controls (P < 0.001), while high density lipoprotein (HDL) was significantly lower in the former (P < 0.001). In addition, there was a significant relationship between severity of psoriasis and serum lipid profile. The results have revealed the higher plasma level of lipids in psoriatic patients. This may elevate the risk of atherosclerosis, particularly cardiovascular disorders. Therefore, from the epidemiological point of view, screening psoriatic patients, particularly those with severe psoriasis, is recommended.

Infantile Haemangiomas (IH) are the most common vascular tumors occurring in early childhood, with a prevalence of approximately 5-10% of infants. These vascular tumors are divided into two main groups including; infantile haemangioma and vascular malformations. Although, haemangioma of infancy are common, benign and self-limited tumors, a significant percent of these lesions are associated with substantial morbidity in infancy and childhood. All currently used treatments have significant risks. Dramatic improvement of complicated haemangioma of infancy to propranolol was recently reported. Herein, we review infantile haemangioma as a whole with focus on the therapeutic efficacy of systemic and topical propranolol as a beta-blockers for the management of infantile haemangioma.

Background and Psoriasis is a common chronic and recurrent inflammatory skin disorder characterized by hyper proliferation of keratinocytes and infiltration of T cells, monocytes/macrophages and neutrophils to dermis and epidermis. Prevalence of cardiovascular disorders is remarkable in patients with psoriasis compared to normal individuals. Psoriasis is believed to have associations with hyperlipidemia. This study was designed to investigate the serum lipid profile in psoriatic patients and its association with the severity of disease. In this case-control study 50 plaque type psoriasis patients and 50 healthy controls were evaluated in Mazandaran University of Medical Sciences, 2012. The blood samples were collected after 14 h in fasting condition. The serum triglyceride, cholesterol and lipoproteins were assayed using a standard kit. Some parameters including serum triglyceride, cholesterol, low density lipoprotein (LDL), and very low density lipoprotein (VLDLS) level were significantly higher in the case group (P<0.001). The high density lipoprotein (HDL) level was significantly lower in the case group (P<0.001). We found a significant relationship between severity of psoriasis and serum lipid profile level. Results revealed higher plasma level of lipid profile in psoriatic patients. Therefore, to decrease the risk of cardiovascular disease monitoring the serum lipid profile level is necessary in psoriatic patients.

Candida is a member of normal flora of human skin and mucosa which cause a wide range of skin infections as cutaneous candidiasis. Considering the pathogenesis of acne, predisposing factors and microbial agents which involve in acne, and the pathogenicity of Candida in causing skin diseases, this study evaluated the prevalence of Candida in skin and acne lesions of patients to analyze its probable role in acne. A total number of 125 patients (70 females and 55 males) enrolled in this study. The samples were collected from inside and surface of acne lesions. Direct microscopic examination was performed with 20% potassium hydroxide (KOH) + calcofluor white (CFW). The collected samples were also cultured on Sabouraud's dextrose agar with chloramphenicol (SC). The isolated species were identified by morphologic and physiologic methods such as culture on chrome agar Candida media, germ tube test, chlamydospore forming test on cornmeal agar media, growth in 45˚c, and sugar assimilation test with HiCandida identification kit (HiMedia, Mumbai, India). Among all collected samples from inside of acne lesions, 45.6% were positive for yeast cells in direct microscopic examination. Moreover, 45 samples (36.0%), 11 cases (24.4%) from inside of acne lesions and 34 cases (75.6%) from skin surface, were positive for Candida colony growth in culture. Candida parapsilosis and Candida krusei were the most frequent isolated species from inside of acne lesions and skin surface, respectively. In 5 cases (11.1%), Candida was simultaneously found in both inside of acne lesions and skin surface samples. According to the results of our study, Candida is a normal flora of skin which can be considered in the etiology of acne. We also recommend further studies with a larger sample size and specific aims in the future.

Background and Âtopic dermatitis (ÂD) is a chronic or relapsing inflammatory skin disease which affects 10–20% of children and 1-3% of adults. Âttention has recently been focused on microbial agents, particularly fungi as aggravating factors of ÂD. Fungi can be found throughout the world. Some of fungal genera are as the normal flora, and some of them are abundantly found in the environment. The purpose of this study was to review on recent knowledge concerning the pathogenesis of ÂD in relation to the role of fungi. Â comprehensive literature search of published studies from 1966 until 2011 in PubMed/MËDLÏNË and Ïranian databases regarding role of fungi in ÂD was performed Malassezia, Çandida, Âlternaria and Çladosporium were the most common fungi which the most studies addressed their role in atopic dermatitis. Frequency of Çandida and Malassezia-colonization were higher in ÂD patients than in control group; moreover the presence of type Ï hypersensitivity reaction to Malassezia, Çandida, Âlternaria and Çladosporium were seen in a significant percentage of patients with ÂD. Çonclusion: Fungi are an important source of allergens which can trigger cutaneous inflammation in patients with ÂD. Therefore, we suggest that clinicians pay attention to screen and treatment of fungal hyper colonization and type Ï hypersensitivity reaction to fungi in patients with ÂD especially in patients who do not respond to traditional treatment

Background and Malassezia is one of the etiologic agents of skin disorders such as acne and opportunistic pathogen for invasive infections. Âs no published evidence was found on the distribution of Malassezia in acne lesion in Mazandaran province، the present study was carried out to determine the prevalence of Malassezia in acne lesions in patients referred to dermatology clinic of Booali hospital in Sari city and to evaluate the susceptibility of isolated species to ketoconazole (KTZ‚ miconazole (MÏZ) and clotrimazole (ÇLZ). Ïn the present study، 122 patients (66 female and 56 male) were recruited. Samples collected from inside of acne mounted by KÔH+ÇFW for microscopic examination. Samples were also cultured using Leeming-Notman medium. The isolated species were identified by their morphologic and physiologic characteristics and confirmed by molecular method. Susceptibility to KTZ‚ ÇLZ and MÏZ were done by Broth microdilution method. Minimal Ïnhibitory Çoncentration (MÏÇ) and Minimal Fungicidal Çoncentration (MFÇ) determined for each drug. Ïn total، 60 cases (49. 2%) were positive for yeast cells in direct microscopic examination. Yeast like fungi growth was positive in 23 samples. Malassezia furfur was obtained in 3 cases (2. 5%). Çandida species were identified in other cases. The MÏÇ ranges were 0. 03-2 µg/ml، 4-16 µg/ml and 2-16 µg/ml for KTZ‚ ÇLZ and MÏZ، respectively. The MFÇ ranges were 0. 03-2 µg/ml، 8-16 µg ml and 4-16 µg/ml for KTZ‚ ÇLZ and MÏZ، respectively. Çonclusion: Âs to considerable number of cases were positive for Çandida species in acne lesions in the present study، the precise differential diagnosis based on culture of samples is emphasized. The results demonstrated that KTZ is the most effective imidazole against Malassezia furfur isolates.

Background and Chronic idiopathic urticaria (CIU) is a recurrent disorder that is characterized by itching wheels lasting more than 6 weeks. Etiology of CIU is unknown. The aim of this study is to assess the efficacy of Helicobacter pylori (Hp) infection eradication in improvement of CIU.In this double blind placebo-controlled clinical trial, 60 CIU patients were enrolled in the study. Urea breath test (UBT) was performed for indicating the Hp infection. Hp positive patients were divided in 2 groups: cases that were treated with quadruple therapy for eradication of Hp(Amoxicillin, Omeprazole, Bismuth and Metronidazole) and controls (placebo). The gastrointestinal (GI) and dermatologic symptoms and signs were recorded and compared in the beginning of the study, and 1 and 3 months after the treatment.From 60 CIU patients, 32 (53%) were UBT positive. 15 cases and 13 controls completed the study. There were no significant statistical differences between the two groups for their GI and dermatologic complaints before intervention, and 1 and 3 months after eradication, except for pyrosis that was improved in cases after 3 months (P= 0.029)Eradication of Hp does not have any effect on improving CIU symptoms or signs.

Introduction. Cutaneous and mucosal disorders are of the common problems in patients on long-term hemodialysis. The aim of this study was to evaluate the frequency of dermatologic problems among patients with end-stage renal disease (ESRD) who receive maintenance hemodialysis. Materials and Methods. One hundred and one patients with ESRD on hemodialysis were studied. All of patients were fully examined for cutaneous, nail, hair, and mucosal changes by a single dermatologist. Complementary diagnostic measures such as biopsy of the lesions were carried out, where necessary. The patients were 43 (42.6%) women and 58 (57.4%) men with a mean age of 50.0 ± 12.3 years. The duration of hemodialysis was 36.0 ± 11.0 months. Dermatologic examination revealed that 95 patients (94.1%) suffered from cutaneous problems. Skin discoloration (66.3%) was the most common skin lesion. Pruritus was seen in 38.6% of the patients. Hair, mucous membrane, and nail problems were present in 37.6%, 23.8%, and 43.6% of the patients, respectively. There was a significant association of the number of cutaneous manifestations with the age of the patients (P =. 001), but not with hemodialysis duration. The most common hair disorder was hair loss in 9.9% of the patients and the most common oral mucosal problem was furred tongue (7.9%). Of the nail disorders, nail bed paleness (16.8%) was the most common. Conclusions. Cutaneous and mucosal lesions in patients with ESRD can vary from each patient population to another. Factors such as diagnostic accuracy, climate, and early treatment influence some disorders such as pruritus, xerosis, and infections.