Actinic damage in the skin of patients on haemodialysis for chronic renal failure.
Seventy-nine patients on long-term haemodialysis for chronic renal failure were interviewed and examined as to ethnic origin, actinic habits and the occurrence of blisters, skin fragility and slow healing of the skin of the dorsal part of the hands. On clinical examination, the 6 patients (7.5%) with blisters of the dorsal part of the hands had more damaged skin at that site than would be expected for their age. They also tended to be predominantly of English descent with blue eyes, poorer skin tanning ability and increased net exposure to sunlight. A skin imprint method for the grading of actinic damage showed a statistically significantly increased degree of actinic damage in the haemodialysis patients compared to a control group of healthy individuals matched for age and sex, the difference being more pronounced in the 35-64 year age group. Plasma and erythrocyte porphyrin levels were not related to the degree of actinic damage. It is suggested that reduction of the actinic load on the dermis by avoiding excessive exposure to sunlight might minimize the extent of skin changes in haemodialysis patients.