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Dermatologists Provide Unique Evidence of Possible Cause of Rare Skin Condition

While kidney failure is a serious condition that requires extensive medical intervention, a small subset of these patients are prone to developing another grave condition known as Nephrogenic Systemic Fibrosis or Nephrogenic Fibrosing Dermopathy (NSF/NFD). // First recognized as a disease in 1997, NSF/NFD causes discoloration and thickening or tightening of the skin, resulting in pain, muscle weakness and difficulty bending joints. In many cases, NSF/NFD results in scarring of internal organs that inhibit their ability to function properly, which can be fatal.

More than 215 cases of NSF/NFD have been documented in the last decade, but despite ongoing research, the cause of the disease is unknown. Now, results of a pilot study suggest that gadolinium-containing contrasting agents used for Magnetic Resonance Angiography (MRA) in patients with kidney failure may be the culprit.

In the report entitled, “Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis,” to be published in an upcoming issue of the Journal of the American Academy of Dermatology, dermatologist Whitney A. High, MD, MEng, Department of Dermatology at the University of Colorado, Denver, Colo., found that gadolinium was detected in tissue samples from four of seven patients with NSF/NFD.

“Although gadolinium-based contrast agents have a long history of safe and effective use in Magnetic Resonance Imaging (MRI), the dose of the agent administered to kidney failure patients undergoing MRA to examine blood vessels is up to three times higher than the amount used in a typical MRI test,” explained Dr. High. “Recent publications have suggested an association between exposure to gadolinium and the development of NSF/NFD, and our pilot study was designed to determine whether gadolinium was detected within the skin and soft tissue of patients with the disease who were exposed to this contrast agent.”

Dr. High and a team of researc
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