Necrobiosis lipoidica is a rare, chronic skin condition predominantly associated with diabetes mellitus (known as necrobiosis lipoidica diabeticorum or NLD).[1] It can also occur in individuals with rheumatoid arthritis or without any underlying conditions (idiopathic).[2] It is characterized by hardened, raised areas of the skin, often appearing on the shins, with a yellowish center and a surrounding dark pink area. The lesions are generally asymptomatic but can become tender and ulcerate when injured.
The exact cause of this condition is not known, but it involves collagen degeneration and a granulomatous response in the layer of the skin called the dermis, often affecting the deeper fat layer and thickening dermal blood vessels.
Diagnosis is confirmed through a skin biopsy showing inflammatory cell infiltrate and necrotising vasculitis. Treatments like PUVA therapy, photodynamic therapy, low dose aspirin, and corticosteroids are used to manage symptoms, as there is no cure.
It affects approximately 0.3% of diabetics, showing a higher prevalence in women (3:1 female-to-male ratio).
^Dennis, Mark; Bowen, William Talbot; Cho, Lucy (2012). "Necrobiosis lipoidica diabeticorum". Mechanisms of Clinical Signs. Elsevier. p. 541. ISBN 978-0729540759; pbk{{cite book}}: CS1 maint: postscript (link)
^James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
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