Yasmeena Khan, Farzana Aziz, Iffat Yazdani.
Telogen Effluvium in a patient on Hemodialysis - A case report and review of literature.
J Pak Assoc Derma Jan ;13(1):43-4.

A twenty year old female was admitted to the Nephrology ward with high grade fever since 12 days and mouth ulcers since one week. She was a known case of end stage renal disease (ESRD) secondary to chronic interstitial nephritis and was on haemodialysis thrice weekly since one year. On examination the patient had a temperature of 103°F, and painful ulcers on gingiva and mucosa of cheeks. Halitosis was troublesome. Rest of the systems were normal. Blood Urea = 82 mg% S. Creatinine = 6 mg% Hb = 8 gm/dl Rest of the Biochemical and Haematological parameters were normal. The patient was treated with Acyclovir 400 mg five times daily. The mouth ulcers improved a :d pyrexia subsided in five days. But there was abrupt fall of 80% of scalp hair a week later. The diagnosis of telogen effluvium was confirmed by finding a positive hair pull.

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