Acroangiodermatitis Associated with Hemodialysis Access Dysfunction: A Rare Manifestation of Central Vein Stenosis

Vascular access is a fundamental element in hemodialysis therapy. Although arteriovenous fistula (AVF) is the preferred access, the use of a central venous catheter (CVC) is often inevitable. The use of CVC may lead to long-term complications such as central vein stenosis (CVS), which encompasses a wide range of clinical presentations. In rare cases, chronic venous hypertension may lead to acroangiodermatitis (AAD), an uncommon cutaneous manifestation. Here, we report the case of a 53-year-old man with end-stage renal disease on long-term hemodialysis, presented with progressive right upper limb edema and a crusted ulcer extending from the shoulder to the fingers. The patient had a history of multiple vascular accesses, including CVC and AVFs. Acroangiodermatitis was diagnosed based on dermoscopic and histopathological findings. This case highlights a complex vascular access complication in a hemodialysis patient that required a multidisciplinary approach. Early detection and prompt management of CVS and its complications, including acroangiodermatitis, are crucial for improving patient outcomes.