Nephrogenic fibrosing dermopathy is a rare, recently described fibrotic skin condition that primarily affects patients with a history of renal disease. We describe 2 patients on hemodialysis with the characteristic clinical and pathologic features. Nephrogenic fibrosing dermopathy should be distinguished from other fibrotic disorders, such as scleromyxedema, systemic sclerosis, and eosinophilic fasciitis