Diagnosis
The following procedures may be used to diagnose VUR:

Cystography
Fluoroscopic voiding cystourethrogram (VCUG)
Abdominal ultrasound
Technetium-99m Dimercaptosuccunic Acid (DMSA) ScintigraphyAn abdominal ultrasound might suggest the presence of VUR if ureteral dilatation is present; however, in many circumstances of VUR of low to moderate, even high severity, the sonogram may be completely normal, thus providing insufficient utility as a single diagnostic test in the evaluation of children suspected of having VUR, such as those presenting with prenatal hydronephrosis or urinary tract infection (UTI).VCUG is the method of choice for grading and initial workup, while RNC is preferred for subsequent evaluations as there is less exposure to radiation. A high index of suspicion should be attached to any case where a child presents with a urinary tract infection, and anatomical causes should be excluded. A VCUG and abdominal ultrasound should be performed in these cases
DMSA scintigraphy is used for the evaluation of the parenchymal damage, which is seen as cortical scars. After the first febrile UTI, the diagnostic role of an initial scintigraphy for detecting the damage before the VCUG was investigated and it was suggested that VCUG can be omitted in children who has no cortical scars and urinary tract dilatation.Early diagnosis in children is crucial as studies have shown that the children with VUR who present with a UTI and associated acute pyelonephritis are more likely to develop permanent renal cortical scarring than those children without VUR, with an odds ratio of 2.8.
Keratoderma is a hornlike skin condition. Classification
The keratodermas are classified into the following subgroups:: 506

Congenital
Simple keratodermas
Diffuse palmoplantar keratodermas
Diffuse epidermolytic palmoplantar keratoderma
Diffuse nonepidermolytic palmoplantar keratoderma
mal de Meleda
Focal palmoplantar keratoderma
Striate palmoplantar keratoderma
Punctate palmoplantar keratoderma
Keratosis punctata palmaris et plantaris
Spiny keratoderma
Focal acral hyperkeratosis
Complex keratodermas
Diffuse palmoplantar keratoderma
Erythrokeratodermia variabilis
Palmoplantar keratoderma of Sybert
Olmsted syndrome
Naegeli–Franceschetti–Jadassohn syndrome
Focal palmoplantar keratoderma
Papillon–Lefèvre syndrome
Pachyonychia congenita type I
Pachyonychia congenita type II
Focal palmoplantar keratoderma with oral mucosal hyperkeratosis
Camisa disease
Ectodermal dysplasias
Cloustons hidrotic ectodermal dysplasia
Acrokeratotic poikiloderma
Dermatopathic pigmentosa reticularis
Syndromic keratodermas
Vohwinkel syndrome
Palmoplantar keratoderma associated with esophageal cancer
Palmoplantar keratoderma and spastic paraplegia
Naxos disease
Striate palmoplantar keratoderma, woolly hair, and left ventricular dilated cardiomyopathy
Keratitis-ichthyosis-deafness syndrome
Corneodermatosseous syndrome
Huriez syndrome
Oculocutaneous tyrosinemia
Cardiofaciocutaneous syndrome
Schöpf–Schulz–Passarge syndrome

Acquired
Acquired keratodermas
AIDS-associated keratoderma
Arsenical keratoses
Calluses
Climacteric keratoderma
Clavi (Corns)
Eczema
Human papillomavirus
Keratoderma blenorrhagicum
Lichen planus
Norwegian scabies
Paraneoplastic keratoderma
Psoriasis
Reactive arthritis
Secondary syphilis
Tinea pedis
Sézary syndrome
Tuberculosis verrucosa cutis
Drug-induced keratoderma

See also
Palmoplantar keratoderma
Skin lesion
List of cutaneous conditions
List of conditions caused by problems with junctional proteins

References


== External links ==