Clinical and morphological features of necrobiosis lipoidica

Severson, Kevin J.; Costello, Collin M.; Brumfiel, Caitlin M.; Patel, Meera H.; Butterfield, Richard J.; Nelson, Sara; Pittelkow, Mark R.; Mangold, Aaron R.

doi:10.1016/j.jaad.2021.04.034

Cited by 12 publications

(24 citation statements)

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“…Eosinophils in the subcutaneous tissue may play a role in alternative macrophage activation and glucose metabolism, as they have been found to inversely correlate with insulin resistance 14 . This is similar to the authors' recent reports of clinical data supporting the notion that there are different underlying drivers of NL between diabetics and nondiabetics 4 . Again, the pathogenesis of this remains unclear but could be because of the broader reactivity of the patients.…”

Section: Discussionsupporting

confidence: 84%

“…14 This is similar to the authors' recent reports of clinical data supporting the notion that there are different underlying drivers of NL between diabetics and nondiabetics. 4 Again, the pathogenesis of this remains unclear but could be because of the broader reactivity of the patients. Neutrophils were seen more commonly in diabetics than nondiabetics (45.2% vs. 17…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, NL (previously termed necrobiosis lipoidica diabeticorum) presents as atrophic, yellow‐to‐reddish papules or plaques on the bilateral lower extremities 3 . Ulceration occurs in 12.7%–30% of lesions present located outside the characteristic pre‐tibial site, as occurs in up to 10% of cases 4,5 …”

Section: Introductionmentioning

confidence: 99%

“…Previously, authors have attempted to differentiate NL in patients with and without diabetes clinically and histopathologically. Clinically, patients with diabetes tend to present younger than patients without diabetes 4,5 . Histopathologically, authors have noted lesions of NL associated with diabetes show more necrobiosis, less apparent “tuberculoid” or epithelioid cell response, 9 and increased presence of vasculitis or thrombogenic vasculopathy 10 .…”

Section: Introductionmentioning

confidence: 99%

“…diabetes. 4,5 Histopathologically, authors have noted lesions of NL associated with diabetes show more necrobiosis, less apparent "tuberculoid" or epithelioid cell response, 9 and increased presence of vasculitis or thrombogenic vasculopathy. 10 Despite these attempts, it is thought that NL is the same disorder in diabetic and nondiabetic patients but with unique triggers for the inflammatory reaction.…”

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confidence: 99%

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Histopathologic features of necrobiosis lipoidica

et al. 2022

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Background Necrobiosis lipoidica (NL) is an uncommon granulomatous dermatosis that can occur in patients with or without associated diabetes mellitus (DM). Prior studies have attempted to determine distinctive histopathologic features of NL in patients with and without DM. Methods A retrospective review of 97 patients with NL was performed to determine the similar and distinctive histopathologic features in patients with DM and without DM. Results Of the 97 patients, 32% (n = 31) had DM. Epidermal acanthosis was seen more commonly in diabetics than nondiabetics (32.3% vs. 12.1%; p = 0.017). Naked (sarcoidal/tuberculoid) granulomas were more frequently observed in nondiabetics than diabetics (22.7% vs. 3.2%; p = 0.016). Eosinophils were more common in nondiabetics than diabetics (38.5% vs. 9.7%; p = 0.004), while neutrophilic infiltration was more common in diabetics than nondiabetics (45.2% vs. 17.5%; p = 0.004). Conclusions This study corroborates well‐documented histopathologic features of NL and shows distinctive histopathologic features of NL among patients with DM‐I, DM‐II, and without DM. These results support the hypothesis that there are different underlying drivers of NL between diabetics and nondiabetics.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%