A case of disseminated perforating necrobiosis lipoidica

Gori, Niccolò; Stefani, Alessandro; Luca, Emilia; Peris, Ketty

doi:10.1002/ccr3.2766

Cited by 8 publications

(24 citation statements)

References 10 publications

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“…Main locations of PNL are similar to the classic NL. Two cases of PNL with disseminated lesions have been described, although none with a single lesion in the upper limbs 2 . As in NL, epidermoid carcinoma has been reported in PNL lesions 3 , but in our patient, there were no signs of malignant transformation after 3 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Perforating necrobiosis lipoidica in an old surgical scar

Relvas¹,

Morgado²,

Cardoso³

et al. 2023

PJDV

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Necrobiosis lipoidica (NL) is an idiopathic granulomatous disease, frequently associated with diabetes mellitus. Histologically, it is characterized by palisaded granulomas involving the deep dermis, but the epidermis is usually spared. We describe a case of perforating NL (PNL), a rare variant of NL, occurring in an atypical location-an old surgical scar on the elbow-in a 70-year-old, non-diabetic, female patient. Histopathological examination of a skin biopsy demonstrated a palisading granulomatous infiltrate involving the full dermis, with an area of epidermal invagination and transepithelial elimination of necrotic material. Clinically, the particularity of PNL is the presence of multiple hyperkeratotic plugs or plaques, within a typical lesion of NL, which correspond to the necrobiotic material being eliminated through the epidermis. Treatment of PNL is still challenging, mainly due to its rarity. Our patient was treated with clobetasol propionate ointment 0.05% one daily, with significant improvement.

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Section: Discussionmentioning

confidence: 99%

Perforating necrobiosis lipoidica in an old surgical scar

Relvas¹,

Morgado²,

Cardoso³

et al. 2023

PJDV

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“…El diagnóstico clínico de NLP sólo se puede realizar a través de una correlación clínico-histopatológica precisa. 11 La dermatoscopia puede ser una herramienta útil en el diagnóstico de esta rara variante, ayudando a visualizar las características típicas, como lo son un fondo blanquecino/amarillo y vasos lineales irregulares, que son sugestivos de enfermedad granulomatosa. Además, la identificación de estructuras similares a aberturas en forma de comedón (que representan áreas de tejido conectivo degenerado) hacen sospechar que se trata de un trastorno cutáneo perforante.…”

Section: Diagnósticounclassified

“…En este contexto, los inhibidores del TNF-α demuestran ser eficaces en el control de la formación de granulomas. 5,6,11 En 2019 Nunes de Mattos y colaboradores 4 reportaron el caso de un paciente con buena respuesta al tratamiento con adalimumab.…”

Section: Tratamientounclassified

Necrobiosis lipoídica perforante

Jiménez-Hernández¹,

González-González²,

Meza-Gaxiola³

2022

Revista Del Centro Dermatológico Pascua

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Las dermatosis perforantes constituyen un grupo de enfermedades caracterizadas clínicamente por la eliminación transepidérmica de diversos materiales cutáneos. En las dermatosis perforantes secundarias la perforación y eliminación de las fibras del tejido conjuntivo son un fenómeno ocasional, que ocurre acompañando a otras dermatosis crónicas, tales como la necrobiosis lipoídica (NL). La variedad perforante (NLP) es aún menos frecuente, con pocos casos reportados en la literatura. La diabetes mellitus 2 (DM2) se asocia en 90-100% de los casos. El diagnóstico definitivo sólo se puede realizar a través de una correlación clínico-histopatológica. La histopatología muestra la eliminación del material necrobiótico a través del canal folicular, además de los granulomas en «empalizada» con necrobiosis de la colágena. La enfermedad tiene un curso crónico con tendencia a la cicatrización, ulceración y en algunos casos la evolución hacia carcinomas. El tratamiento de la NL y la NLP es difícil, debido a lo poco frecuente de la enfermedad y falta de ensayos clínicos al respecto. En este artículo presentamos el caso de un paciente de 63 años con necrobiosis lipoídica perforante con reciente diagnóstico de DM2.

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“…The lower legs are typically involved but lesions can appear on the upper extremities and torso. 3 There are only 22 previously reported cases of PNL; however, ;90% of cases are associated with DM. [3][4][5][6] Although granuloma annulare (GA), sarcoidosis, and rheumatoid nodules can present generalized with focal ulceration and perforation, histopathologic morphology is valuable in differentiation.…”

Section: Diagnosismentioning

confidence: 99%

“…3 There are only 22 previously reported cases of PNL; however, ;90% of cases are associated with DM. [3][4][5][6] Although granuloma annulare (GA), sarcoidosis, and rheumatoid nodules can present generalized with focal ulceration and perforation, histopathologic morphology is valuable in differentiation. Nodular granulomatous infiltrates with a paucity of inflammatory cells characterizes sarcoidosis, whereas dermal deposits of amorphous eosinophilic material surrounded by palisading granulomatous infiltrate are seen in rheumatoid nodules.…”

Section: Diagnosismentioning

confidence: 99%