类脂质渐进性坏死1例

类脂质渐进性坏死是一种代谢障碍性疾病，由于多伴发糖尿病，故又名糖尿病性类脂质渐进性坏死。我们在临床诊治1例被误诊为结核样型麻风的类脂质渐进性坏死患者，现报告如下。     

非糖尿病性类脂质渐进性坏死1例

类脂质渐进性坏死是一种代谢障碍性疾病,由于多并发糖尿病,故又名糖尿病性类脂质渐进性坏死.笔者诊治1例非糖尿病性类脂质渐进性坏死,现报告如下.     

类脂质渐进性坏死2例

类脂质渐进性坏死是一种真皮结缔组织变性疾病,临床常表现为胫前大片硬皮病样斑块.由于该病多并发糖尿病,故又名糖尿病性类脂质渐进性坏死.我们遇到2例类脂质渐进性坏死病例,现报道如下. 临床资料 例1女,58岁.因双小腿斑块4年余,局部溃疡1年余来诊.4年前患者无明显诱因左小腿下段内侧及右小腿中段伸侧出现红褐色丘疹、斑丘疹,无痒痛,皮损逐渐增大、增多、增厚,形成较大的斑块.先后外用"皮炎平"、"艾洛松"等无好转.     

类脂质渐进性坏死2例

类脂质渐进性坏死是一种真皮结缔组织变性疾病，临床常表现为胫前大片硬皮病样斑块。由于该病多并发糖尿病，故又名糖尿病性类脂质渐进性坏死。我们遇到2例类脂质渐进性坏死病例，现报道如下。     

姐妹同患非糖尿病性类脂质渐进性坏死

类脂质渐进性坏死(necrobiosis lipoidica, NL)是一种代谢障碍性疾病,由于多并发糖尿病,故又称为糖尿病性类脂质渐进性坏死,而非糖尿病性类脂质渐进性坏死(non-diabetic necrobiosis lipoidica),尤其是具有家族遗传倾向的病例十分少见.2009年5月笔者诊治1例姐妹同患非糖尿病性类脂质渐进性坏死,现报告如下.     

非糖尿病性类脂质渐进性坏死1例

类脂质渐进性坏死是一种代谢障碍性疾病,由于多伴发糖尿病,故又称为糖尿病性类脂质渐进性坏死,而非糖尿病性类脂质渐进性坏死病例十分少见,我们于2007年4月诊治1例,获得显著疗效,报告如下。     

类脂质渐进性坏死7例临床及组织病理学分析

类脂质渐进性坏死（necrobiosis lipoidica，NL)又称糖尿病性类脂质渐进性坏死，近几年发病率有增多趋势。现将我们自2002-2004年诊断的7例，作回顾分析如下。     

非糖尿病性类脂质渐进性坏死一例

报告1例非糖尿病性类质脂渐进性坏死。患者男,37岁,右小腿胫前结节、斑块13年,加重1年。无糖尿病史。皮损组织病理检查符合类质脂渐进性坏死特征。给予口服环孢素联合局部注射曲安奈德注射液治疗后,皮损逐渐消退,随访2年未见复发。     

类脂质渐进性坏死8例临床分析

目的:了解类脂质渐进性坏死的临床特征,提高对本病的认识。方法:对8例确诊的类脂质渐进性坏死患者的临床资料进行相关分析。结果:类脂质渐进性坏死为好发于女性的慢性肉芽肿性皮肤病,临床表现为胫前紫红色至红褐色斑块,边缘隆起,中央为黄褐色萎缩伴毛细血管扩张,常伴发糖尿病。病理特征为栅栏状肉芽肿性皮炎,呈层状外观。结论:类脂质渐进性坏死临床较罕见,加强对该病的认识,有助于减少误诊,及早明确诊断。     

糖尿病类脂质渐进性坏死1例并29例文献分析

患者女,68岁。双胫前水肿性红斑伴局部萎缩10年,确诊为糖尿病3年,经组织病理检查明确诊断为糖尿病类脂质渐进性坏死。并回顾文献及29例病例,对本病临床特征进行了分析。     

Necrobiosis-lipoidica-like skin manifestation in lymphomatoid granulomatosis (Liebow)

A 58-year-old man developed 3 indurative erythematous lesions like necrobiosis lipoidica on the right lower leg. He had had similar cutaneous lesions 1.5 years previously. These had been surgically excised, and a histologic diagnosis of necrobiosis lipoidica was made at another hospital. He was diagnosed as having lymphomatoid granulomatosis by lung biopsy in our hospital. Nasal involvement was confirmed in later examinations and the skin lesions were also considered to be the cutaneous manifestation of lymphomatoid granulomatosis. This outlines that cutaneous manifestations may allow early diagnosis of lymphomatoid granulomatosis.     

Necrobiosis lipoidica of the glans penis

We report a 65-year-old diabetic man with necrobiosis lipoidica occurring on the glans of penis. He was initially seen with chronic ulcerative balanitis that eventually healed with strict control of diabetes mellitus, cystostomy, and pentoxifylline, leaving heavily depressed scars. Penile necrobiotic palisading granulomas include necrobiosis lipoidica and granuloma annulare. On the basis of the literature review, these 2 diseases manifest different skin lesions.     

Necrobiosis lipoidica diabeticorum: a clinicopathologic study

Necrobiosis lipoidica diabeticorum is an unusual dermatologic condition with a characteristic clinical appearance and a clear association with diabetes mellitus. There is currently no treatment that reverses the atrophic changes associated with this lesion. We have carried out a clinicopathologic study on 15 subjects and, in addition, have reviewed 10 further biopsy specimens of necrobiosis lipoidica diabeticorum. We found a frequent association of necrobiosis lipoidica diabeticorum with other chronic complications of diabetes mellitus, including limited joint mobility. It is possible that nonenzymatic glucosylation or other changes in collagen may be important in the etiology of necrobiosis lipoidica diabeticorum and the limited joint mobility. We confirmed that cutaneous anesthesia is usually present in the necrobiosis lipoidica diabeticorum lesions. With the use of an antibody to S100 protein and an immunohistochemical method, there was an apparent decreased number of nerves in the skin lesions. We suggest that sensory loss results from local destruction of cutaneous nerves by the inflammatory process. Finally, in six elliptical biopsies extending into clinically normal skin, we demonstrated that the inflammatory infiltrate of necrobiosis lipoidica diabeticorum extended from the lesion into apparently normal skin surrounding clinically active lesions. Thus, intradermal steroids might be administered to perilesional areas surrounding active lesions in the hope of halting progression.     

SQUAMOUS CARCINOMAS DEVELOPING IN BILATERAL LESIONS OF NECROBIOSIS LIPOIDICA

Squamous cell carcinomas developed in bilateral pretibial lesions of necrobiosis lipoidica in a 39 year old non-diabetic male. The tumours and areas of necrobiosis were successfully excised and repaired with full thickness skin grafts. Despite the chronic scarring and at times ulcerative nature of necrobiosis lipoidica, complicating squamous cell carcinomas have infrequently been reported.     

Transcutaneous measurement of oxygen and carbon dioxide pressure in necrobiosis lipoidica

Transcutaneous measurement of oxygen pressure (PcO2) and carbon dioxide pressure (PcCO2) was performed in nine patients with histologically confirmed necrobiosis lipoidica. None of the patients had diabetes mellitus. All measurements were taken at the lower leg. In each case, the atrophic center, the inflamed border, and the surrounding clinically normal skin of necrobiosis lipoidica were examined at 44 degrees C sensor temperature (maximal vasodilatation). Statistically significant hypoxia was found in the area of necrobiosis lipoidica, which was even more pronounced in the inflamed border. Inhalation of 100% oxygen provoked a marked increase in the PcO2 in the lesion, but the values were still significantly lower than in the normal skin. At the edge of the lesions the PcCO2 was significantly elevated. These findings support a vascular origin of necrobiosis lipoidica, involving reduced vascular perfusion combined with diffusion block.     

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.     

Increased plasma fibronectin in diabetes mellitus, necrobiosis lipoidica and widespread granuloma annulare

The plasma level of fibronectin was measured in patients with granuloma annulare, necrobiosis lipoidica and diabetes mellitus and compared with levels in healthy controls. A significant increase was observed in necrobiosis lipoidica, generalised granuloma annulare and diabetes but not in patients with solitary lesions of granuloma annulare. The possible role of fibronectin in the development of micro-angiopathy is discussed.     

Healing of severe ulcerative necrobiosis lipoidica with cyclosporin

A 55-year-old woman with severe, chronic, treatment-resistant ulcerating necrobiosis lipoidica of the shins was commenced on oral cyclosporin at a dose of 2.5 mg/kg/day. Improvement started within 1 week of commencing treatment, and the lesions healed completely over 8 months. Further ulceration occurred 3 months after discontinuing cyclosporin, with improvement on reintroduction of cyclosporin. There have been four previous case reports of healing of treatment-resistant ulcerating necrobiosis lipoidica with cyclosporin.     

Necrobiosis lipoidica. Variants on a theme

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 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.