Sir: Nephrogenic systemic fibrosis (NSF), also known as nephrogenic fibrosing dermopathy (NFD), is a rare and recently described condition occurring in association with renal disease. Its most prominent effects are on the skin and it commonly presents as indurated plaques and papules on the extremities and trunk. In longstanding cases, flexion contractures may result. The condition has more recently been shown to be a systemic fibrosing disorder rather than confined to the skin. For this reason, nephrogenic systemic fibrosis is presently the preferred terminology for the condition previously known as NFD
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