Nephrogenic fibrosing dermopathy in a patient with acute renal failure never requiring dialysis

Nephrogenic fibrosing dermopathy (NFD) is a newly recognized cutaneous fibrosing disorder. To date the etiology, pathogenesis, and clinical course remains unknown. The majority of cases have been in renal dialysis or renal transplant patients. Only four cases have been reported in which patients had acute renal failure and never required dialysis. Currently, there is no effective treatment. A 65-year-old man was hospitalized for pneumonia. During hospitalization he developed acute renal failure secondary to acute tubular necrosis. The patient had woody indurated plaques on his upper extremities and trunk, and brown indurated plaques on his trunk. Histopathological examination revealed a spindle cell proliferation infiltrating through the dermis and subcutis with mild mucin deposition. Nephrogenic fibrosing dermopathy is a novel fibrosing disorder diagnosed clinically and histopatholigically. Currently no risk factors other than renal failure have been identified. Our patient is a unique example of NFD observed in acute renal failure secondary to acute tubular necrosis, never requiring dialysis. We also review the four other cases of acute NFD never requiring dialysis that have been reported in the literature.