Nephrogenic systemic fibrosis can begin days to months, and even years, after exposure to an older gadolinium-based contrast agent (group 1). Some signs and symptoms of nephrogenic systemic fibrosis may include: 
Swelling and tightening of the skin
Reddened or darkened patches on the skin
Thickening and hardening of the skin, typically on the arms and legs and sometimes on the body, but almost never on the face or head
Skin that may feel "woody" and develop an orange-peel appearance
Burning, itching or severe sharp pains in areas of involvement
Skin thickening that inhibits movement, resulting in loss of joint flexibility
Rarely, blisters or ulcers
 In some people, involvement of muscles and body organs may cause: 
Muscle weakness
Limitation of joint motion caused by muscle tightening (contractures) in arms, hands, legs and feet
Bone pain, particularly in the hip bones or ribs
Reduced internal organ function, including heart, lung, diaphragm, gastrointestinal tract or liver
Yellow plaques on the white surface (sclera) of the eyes
 The condition is generally long term (chronic), but some people may improve. In a few people, it can cause severe disability, even death.