Clinical Features and Comorbidities of Patients With Necrobiosis Lipoidica With or Without Diabetes

Abstract

IMPORTANCE Necrobiosis lipoidica (NL) is a rare granulomatous condition. Current knowledge of its key features is based on a limited number of studies and case reports, leading to wide variability in the characterization of its defining features, with limited comparison of patients with or without diabetes. OBJECTIVE To evaluate the epidemiologic characteristics, clinical features, and disease associations of NL in patients with or without type 1 or 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS This multicenter retrospective review included 236 patients aged 15 to 84 years who were evaluated and received a diagnosis of NL at the

Ulcerating yellow plaques on the legs

“…In rare cases, lesions may occur on the scalp, face, or upper extremities. 2 NL was high on the clinical differential in this case, given the distribution of lesions. However, careful sampling and examination of the histopathology revealed findings consistent with NXG.…”

“…Diabetes is present as comorbidity in 11% to 65% of patients affected by NL, hence the previous terminology, NL diabeticorum. 2 Despite the association, control of blood glucose levels does not seem to affect the disease course. D. Hyperlipoproteinemia e Incorrect.…”

The role of anti-tumour necrosis factor in wound healing: A case report of refractory ulcerated necrobiosis lipoidica treated with adalimumab and review of the literature

“…2 In a recent retrospective study of 236 American patients with NL, 58.5% had diabetes, with patients with diabetes developing NL earlier in life. 4 Despite this association, gaining control of blood sugars has not been consistently shown to effectively treat NL. 5 Doppler studies have also refuted the role of microvascular ischaemia in NL.…”

Cutaneous Manifestations of Nutritional Excess: Pathophysiologic Effects of Hyperglycemia and Hyperinsulinemia on the Skin

“…[58][59][60] In a recent retrospective study of 236 patients with NL, 58.5% of patients had diabetes. 61 Nevertheless, NL is a rare entity that affects less than 1% of the diabetic population. 60 Given its correlation with diabetes, it has been postulated that the pathogenesis of NL is due to microvascular ischemic changes resulting from prolonged hyperglycemia.…”