Necrobiosis lipoidica and sarcoidosis

The case is described of a female patient with necrobiosis lipoidica of the legs, and a previous history of acute sarcoidosis. There has been only one previous report of an association between necrobiosis lipoidica and sarcoidosis.¹ The relationship between these disorders may be suggested by the known association of sarcoidosis and other granulomatous and necrobiotic disorders.     

Necrobiosis lipoidica

A 58-year-old woman presented with a seven-year history of an eruption on her lower legs that was associated with edema, weeping, pruritus, and a burning sensation. Past medical history included Hashimoto thyroiditis, which was diagnosed eight years prior to presentation. Histopathologic examination was consistent with necrobiosis lipoidica (NL). To our knowledge, NL that is associated with Hashimoto thyroiditis has been described in only one prior report. NL is a chronic, cutaneous, granulomatous condition with degenerative connective-tissue changes of unknown etiology. Our patient responded well to a potent topical glucocorticoid and topical tretinoin. Although our patient did not have diabetes mellitus, 75 percent of patients with NL have diabetes mellitus at the time of diagnosis or will subsequently develop diabetes mellitus. This association with diabetes mellitus mandates screening for glucose intolerance in all patients with NL.     

Necrobiosis lipoidica

A 69-year-old patient presented with different skin lesions all of which belonged to group of necrobiosis lipoidica. The initial histologic diagnosis was actinic granuloma O??Brien. A subsequent biopsy was interpreted as granulomatous necrobiosis lipoidica. The history of these necrobiotic variants is reviewed and exemplarily depicted with this case. Necrobiosis lipoidica is part of the spectrum of granulomatous skin disorders. Although its etiology is unclear, an association with diabetes mellitus is often discussed. Multiple therapeutic options exist, but standardized guidelines for treatment are missing.     

Necrobiosis lipoidica

Necrobiosis lipoidica (NL) is a granulomatous condition with a degenerative connective tissue of unknown etiology very often associated with diabetes. Histopathologically, NL involves all of the dermis and, often, the subcutaneous fat produces a septal panniculitis. There are some changes suggesting the diagnosis of NL, and systemic disease should be considered if there is the presence of necrotizing vasculitis in the skin biopsy. Many theories of pathogenesis have been proposed, and many types of drugs are available for use in its treatment.     

Necrobiosis lipoidica

A 68-year-old woman presented with a 3-year history of asymptomatic, yellow-brown plaques on the lower extremities with trauma-related superficial ulcers. A biopsy specimen was consistent with necrobiosis lipoidica. Necrobiosis lipoidica is a chronic granulomatous dermatitis that is associated with diabetes mellitus; however, its pathogenesis remains unclear. Topical glucocorticoids are first-line therapy; however, no treatment has proven efficacy in double-blind, placebo-controlled studies.     

Necrobiosis lipoidica and Koebner phenomenon

Our report describes a 52-year-old female patient with bilateral foci of necrobiosis lipoidica in pretibial scars. The skin changes appeared 6 months after internal fixation of a tibial fracture in each case.     

Necrobiosis lipoidica sine diabete

Ohne Zusammenfassung     

Necrobiosis lipoidica mimicking cellulitis

A 57-year-old obese patient presented with a 5 month history of tender, indurated, erythematous plaques with superficial ulceration on the right shin. The lesions closely mimicked cellulitis but were unresponsive to antibiotics. Though the patient was not a known diabetic, on investigations she was found to be a diabetic. Histology confirmed the diagnosis of necrobiosis lipoidica. This acutely inflammed presentation of necrobiosis lipoidica is extremely rare.     

Necrobiosis lipoidica ohne Diabetes

Ohne Zusammenfassung