Diffuse necrobiosis lipoidica diabeticorum associated with non-insulin dependent diabetes mellitus

Abstract

We report a case of diffuse necrobiosis lipoidica (NL) which first appeared on the legs and scrotum, before gradually spreading across the back and arms; the patient also suffered from diabetes mellitus, and the NL lesion began to disappear as the diabetes mellitus was controlled. The possible contribution of various glycation and glycoxidation products of collagen to the pathogenesis of NL is discussed.

Periorbital necrobiosis lipoidica diabeticorum: case report

“…The legs are most commonly affected. It has been reported that NLD resolves with good control of diabetes [1,2]. Here we report an unusual case in which NLD developed in the periorbital region.…”

“…The legs are most frequently affected, but NLD can also involve the hands, fingers, and forearms [1,2]. Scalp involvement has been reported in a few cases [3,4].…”

Vulvar Lymphangiectasia in Crohn�s Disease

“…The pathogenesis of necrobiosis lipoidica remains unclear. A proposed role for autoimmunity exists based on demonstration of IgM and immune complexes within NL lesions and dermal microvessels (5,7,9). It may be due to diabetic microangiopathy (1, 6, 7) or a hypoxia-induced vasculopathy (5).…”

“…It may be due to diabetic microangiopathy (1, 6, 7) or a hypoxia-induced vasculopathy (5). Multiple collagen abnormalities have been noted in NL plaques, including abnormal collagen production (1), the accelerated glycation and oxidation of collagen seen in diabetic skin and subsequent increased collagen cross-linking following oxidation (7). Whether it is a primary collagen disorder, or secondary to diabetic changes, NL may be due to collagen degeneration with secondary inflammation and granulomatous change (5, 7).…”

“…Approximately 85% of cases affect the lower leg only (4), although it has been reported to affect the scalp, face, trunk, upper extremities and genitals (5-7). Multiple, generalised lesions are rare, and limited to case reports (4,(7)(8)(9)(10). The perforating variant of necrobiosis lipoidica was first reported in 1977 by Parra (3,11).…”