Nephrogenic Fibrosing Dermopathy: A Review of the Massachusetts General Hospital Experience

Abstract

We have undertaken a review of the Massachusetts General Hospital experience of nephrogenic fibrosing dermopathy (NFD). Twelve cases were identified, and the dermatopathologic features of lesional skin biopsies were examined. We looked systematically at nine parameters and graded each on a scale of 0 (minimal or none) to 3 (highest or most): 1) extent of fibrocytic proliferation, 2) extent of collagen thickening, 3) extent of vascularity, 4) extent of pannicular involvement, 5) extent of elastolysis, 6) presence of mucin, 7) presence of calcification, 8) presence of giant cells, and 9) presence of inflammation. Results demonstrate that fibrocytic proliferation, collagen thickening, inflammation, and vascularity most commonly were classified as grade 1–2; mucin deposition and elastolysis varied from 0–2; pannicular involvement ranged from 1–3; nearly all had calcification grade of 0, and there were no giant cells detected in any of the twelve cases. Comparing our results to published reports suggests that there are some interesting observations. Our cases tended to be less fibrocellular, have less mucin, and have more vascularity than the initial 14 cases described by Cowper et al (2001). The implications of the dermatopathologic findings for clinical course and prognosis are currently being evaluated.