Nephrogenic systemic fibrosis following hair-dye ingestion induced acute renal failure

We report a patient who developed acute renal failure following the ingestion of a hair-dye with a suicidal intent. He was managed by hemodialysis and other symptomatic measures. He developed generalized seizures and underwent MRI scan of the brain using gadolinium containing contrast material followed by development of bilateral and symmetrical thickening and induration of the skin over the extremities and verrucous papules and plaques over the lower back. Skin biopsy and immunohistochemistry showed typical features of nephrogenic fibrosing dermopathy as well as deposits of calcium. Successful management of renal failure resulted in clearing of all skin lesions except a small bony hard plate like area overt the left leg, the biopsy of which showed features of osseous metaplasia.