Findings of osseous sclerotic bodies: a unique sequence of cutaneous bone formation in nephrogenic systemic fibrosis.
Nephrogenic systemic fibrosis (NSF) is a progressive and potentially fatal fibrosing skin disorder found mainly in patients with renal insufficiency. NSF is characterized by thickened and hyperpigmented skin lesions with or without systemic involvement. In essentially all patients, this disease entity has been associated with the administration of gadolinium contrast agents for imaging purposes. Microscopic recognition of this entity remains challenging, as the diagnosis is based on various clinical and histopathologic features that overlap with other fibrosing disorders. No single feature is absolutely specific for NSF. We report a finding of osseous sclerotic bodies with elastin trapping appearing on histopathology in the clinical setting of NSF with hemodialysis-dependent renal failure. Our report of an additional attribute indicative of NSF may aid in making the diagnosis.
Kartono
Francisca
F
Department of Dermatology, Botsford Hospital, Farmington Hills, MI 48335, USA. fkartono@gmail.com
Basile
Amy
A
Roshdieh
Babak
B
Schwimer
Christopher
C
Shitabata
Paul K
PK
D000368:Aged; D002114:Calcinosis / Q000473:pathology*; D003287:Contrast Media / Q000009:adverse effects; D005682:Gadolinium / Q000009:adverse effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D054989:Nephrogenic Fibrosing Dermopathy / Q000473:pathology*
D003287:Contrast Media; D005682:Gadolinium