Clinicopathologic Correlation—Generalized Perforating Plaques: Answer

Abstract

ANSWERB. Generalized perforating necrobiosis lipoidica.

Disseminated perforating necrobiosis lipoidica: A case report and literature review

“…Necrobiosis lipoidica is a rare granulomatous and inflammatory cutaneous disorder characterized by collagen degeneration associated with diabetes mellitus 1 . Clinical manifestations of the perforating form include well‐demarcated yellow‐brown atrophic plaques with comedo‐like papules 2 . Dermoscopy is a useful technique helping to identify perforating type of NL due to its ability to show transepidermal elimination of degenerated collagen as comedo‐like opening and keratotic plug 8 .…”

“…Perforating NL is an even rarer variant of the disease that was first described by Parra et al in 1977 4 with less than 30 cases reported in the literature. Out of these cases, only five were disseminated, and all were found in patients with type 2 DM 2,4–8 . However, to the best of our knowledge, only one previous report has described the dermoscopic pattern of perforating NL 8 .…”

“…1 It is typical for NL to occur in the pretibial region, but it can also occur in less typical and rare locations such as upper extremities, face, trunk, and scalp. 1,2 Controversy still exists concerning the pathogenesis of the disease; however, microangiopathy has been suggested as the primary cause of altered collagen seen in NL. 2 A deposition of glycoprotein in the blood vessel walls of diabetic patients leads to microangiopathy and abnormal collagen fibrils, all considered end organ damage in diabetic patients.…”

“…1,2 Controversy still exists concerning the pathogenesis of the disease; however, microangiopathy has been suggested as the primary cause of altered collagen seen in NL. 2 A deposition of glycoprotein in the blood vessel walls of diabetic patients leads to microangiopathy and abnormal collagen fibrils, all considered end organ damage in diabetic patients. 3 The incidence of NL in diabetic patients is 0.3%-1.2%.…”

“…Out of these cases, only five were disseminated, and all were found in patients with type 2 DM. 2,[4][5][6][7][8] However, to the best of our knowledge, only one previous report has described the dermoscopic pattern of perforating NL. 8 Herein, we present a case of disseminated perforating NL in a 25-year-old woman with type 1 diabetes mellitus along with its dermoscopic pattern.…”