title: Osseous metaplasia in the setting of nephrogenic fibrosing dermopathy.
abstract: BACKGROUND
  Nephrogenic fibrosing dermopathy (NFD) is a new skin-fibrosing disorder associated with renal dysfunction. It is marked by the acute onset of induration involving the upper and lower limbs, and it is characterized by distinctive histopathologic findings.
  
  
  METHODS
  We report the case of a patient on hemodialysis who presented initially with the characteristic clinical and pathological features of NFD. The patient progressively developed painful hyperkeratotic spicules on both thighs and bone metaplasia was confirmed.
  
  
  RESULTS
  Histological studies were performed at different stages of the disease showing an evolution from the well-known initial phase of NFD, characterized by thickening of the dermis, increased number of fibroblast-like cells, and mucin deposits, to an end stage characterized by the presence of dermal ossification.
  
  
  CONCLUSIONS
  We report the exceptional finding of bone metaplasia in the setting of a case of NFD.
authors.affiliation: Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain. diana@aedv.es
authors.forename: Diana P
authors.initials: DP
authors.lastname: Ruiz-Genao
authors.forename: Marta P
authors.initials: MP
authors.lastname: Pascual-Lopez
authors.forename: Savier
authors.initials: S
authors.lastname: Fraga
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Aragüés
authors.forename: Amaro
authors.initials: A
authors.lastname: Garcia-Diez
mesh_terms: D000328:Adult; D001847:Bone Diseases / Q000209:etiology / Q000473:pathology; D005355:Fibrosis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008679:Metaplasia / Q000209:etiology / Q000473:pathology; D009999:Ossification, Heterotopic / Q000209:etiology / Q000473:pathology*; D006435:Renal Dialysis; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology*