title: [Nephrogenic fibrosing dermopathy treated with extracorporeal photopheresis: role of gadolinium?].
abstract: BACKGROUND
  Nephrogenic fibrosing dermopathy is a cutaneous and systemic sclerosis affecting patients with renal failure.
  
  
  METHODS
  A 68-year-old man with renal insufficiency and on dialysis developed hardening of the skin and severe joint contractions. He had previously undergone angiography with gadolinium-containing contrast agents. A skin biopsy confirmed nephrogenic fibrosing dermopathy. The patient was treated by oral steroids followed by extracorporeal photopheresis. An improvement was seen after 12 cycles.
  
  
  CONCLUSIONS
  Treatment of nephrogenic systemic fibrosis is not codified and is normally based on the methods used for other forms of systemic sclerosis. Six cases of patients showing improvement under extracorporeal photopheresis have been published. The physiopathology of the disease is unknown. Gadolinium could act as a triggering agent by attracting circulating fibrocytes in the dermis of patients. Medical authorities recommend avoidance of gadolinium in patients with advanced kidney failure unless strictly necessary.
authors.affiliation: Service de Dermatologie, Université Clermont-Ferrand 1, CHU, Clermont-Ferrand.
authors.forename: R
authors.initials: R
authors.lastname: Kintossou
authors.forename: M
authors.initials: M
authors.lastname: D'Incan
authors.forename: D
authors.initials: D
authors.lastname: Chauveau
authors.forename: G
authors.initials: G
authors.lastname: Bens
authors.forename: F
authors.initials: F
authors.lastname: Franck
authors.forename: M-M
authors.initials: MM
authors.lastname: Dauplat
authors.forename: R
authors.initials: R
authors.lastname: Viraben
authors.forename: P
authors.initials: P
authors.lastname: Déchelotte
authors.forename: P
authors.initials: P
authors.lastname: Souteyrand
mesh_terms: D000368:Aged; D001706:Biopsy; D003287:Contrast Media / Q000009:adverse effects*; D005355:Fibrosis; D019786:Gadolinium DTPA / Q000009:adverse effects*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D017893:Photopheresis; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy; D012595:Scleroderma, Systemic / Q000188:drug therapy* / Q000209:etiology; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA