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Uremic frost
Article in Indian Dermatology Online Journal · November 2014
DOI: 10.4103/2229-5178.144545
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4 authors:
Sujeet Raina Vivek Chauhan
Dr Rajendra Prasad Government Medical College Indira Gandhi Medical College
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Rajesh Sharma Ravi Sharma
Corniche Hospital Heritage Institute of Medical Sciences Bhadwar Varanasi UP
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Through the Lens
Uremic frost
Sujeet Raina, Vivek Chauhan, Rajesh Sharma, Ravi Sharma
Department of Medicine, A 75-year-old male was admitted with pedal
Dr. Rajendra Prasad edema and respiratory distress of two weeks
Government Medical and altered sensorium of two days duration.
College Tanda, Kangra,
According to his attendants, he was a known
Himachal Pradesh, India
case of chronic kidney disease of many years,
and not on regular follow-up. On examination,
deposits of tiny white crystalline material were
observed on his face and feet [Figures 1 and 2].
On investigation the hemoglobin was 7.6 g%,
blood urea was 233 mg%, serum creatinine was Figure 1: Uremic frost on forehead
12 mg%, and serum potassium was 6.7 meq/l.
Arterial blood gas analysis was consistent with
metabolic acidosis. A provisional diagnosis of end
stage renal disease was considered on clinical
grounds, crystalline deposits being uremic frost.
Patient was planned for hemodialysis but had a
sudden cardiac arrest and died.
Uremic frost was first described by Hirschsprung
in 1865. This dermatological disturbance of
advanced chronic kidney disease is rarely
Access this article online observed in developed countries, but is still
Website: www.idoj.in reported from resource poor nations. It occurs
DOI: 10.4103/2229-5178.144545 when high concentration of urea and other
Quick Response Code: nitrogenous waste products accumulate in
sweat and crystallize as deposits on skin after
evaporation. The dermatological differential
diagnoses are retention keratosis, eczema, and
postinflammatory desquamation. However, a
history of end-stage renal disease and the white,
friable, crystalline characteristics of uremic frost
can make its diagnosis easy. To verify that the Figure 2: Uremic frost on feet
Address for crystals are composed of urea or nitrogenous
correspondence: 2. Udayakumar P, Balasubramanian S, Ramalingam KS,
waste, scrapings of the frost can be diluted in
Dr. Sujeet Raina, Lakshmi C, Srinivas CR, Mathew AC. Cutaneous
C-15 Type V Qts, normal saline, which can then be tested for
manifestations in patients with chronic renal failure
Dr. Rajendra Prasad elevated urea nitrogen levels comparable to on hemodialysis. Indian J Dermatol Venereol Leprol
Government Medical blood levels.[1,2] 2006;72:119-25.
College Tanda, Kangra,
Himachal Pradesh - 176 001,
REFERENCES Cite this article as: Raina S, Chauhan V, Sharma R,
India. Sharma R. Uremic frost. Indian Dermatol Online J 2014;5:58.
E-mail: sujeetraina@ Source of Support: Nil, Conflict of Interest: None
1. Mohan D, Railey M. Uremic frost. Kidney Int
gmail.com declared.
2012;81:1153.
S58 Indian Dermatology Online Journal - 2014 - Volume 5 - Supplement Issue 1
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