This patient likely has nephrogenic fibrosing dermopathy | Dermatology

This patient likely has nephrogenic fibrosing dermopathy (NFD). NFD is an acquired, idiopathic disorder that occurs in renal disease patients. It resembles scleroderma or eosinophilic fasciitis clinically and scleromyxedema histopathologically. Large areas of indurated skin with fibrotic nodules and plaques develop. The extremities are most commonly involved, followed by the trunk. The face, palms and soles are almost never involved. Histopathologically, NFD displays a proliferation of dermal fibroblasts and dendritic cells, thickened collagen bundles, increased elastic fibers, and mucin deposition. Serum protein electrophoresis and immunoelectrophoresis results are negative unlike scleromyxedema, and may be helpful to distinguish the two diseases. NFD is usually a chronic, progressive condition, and favorable responses to medical intervention are anecdotal