Nephrogenic fibrosing dermopathy (NFD) is a recently described cutaneous fibrosing disorder seen exclusively in patients with renal failure.1 This entity is characterized by progressive skin hardening and induration and differs from scleromyxedema by the absence of plasma cells on histologic evaluation and a lack of paraproteinemia. It differs from scleroderma in its morphology, distribution, histopathology, and in lacking anti–Scl-70 antibodies.1