Necrobiosis lipoidica and granuloma annulare. Simultaneous occurrence in a patient

Schwartz, M. E.

doi:10.1001/archderm.118.3.192

Cited by 7 publications

(3 citation statements)

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“…In our study, all those patients with polyneuropathic find ings had diabetes. Diabetes was present in 10 of 14 patients studied which supports the earlier findings of diabetes in about two thirds of the patients with NL [1], NL and granuloma annulare have been reported together in the same patient [10], Furthermore, it has been recently reported that patients suffering from NL as well as granuloma annulare and sarcoidosis have a deficiency in granulocyte functions [11], al though normal functions have been reported in another study [12]. This possible impair ment of granulocyte function as well as a finding of factor-VIlI-rclated antigen in the affected skin area of NL [13] in association with local trauma may lead to development of NL.…”

Section: Discussionsupporting

confidence: 87%

Necrobiosis lipoidica: Clinical and Immunofluorescent Study

Laukkanen¹,

Fräki²,

Väätäinen³

et al. 1986

Dermatology

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Fourteen patients with necrobiosis lipoidica (NL) were carefully evaluated clinically and histologically. Ten of these patients (71%) had diabetes and most of them were treated with insulin (8 of 10 patients). Trauma was found as an immediate triggering factor in 6 patients (43%) and a possible preceding factor in 3 more cases. No immunoglobulins were found in the lesional skin of NL. Intradermal injections of histamine in healthy skin of legs led to deposition of immunoglobulins and complement (C3) in skin blood vessel walls in 4 of 12 patients studied (30%). These results suggest that immune complexes might be involved only in few cases of NL. Preceding trauma combined with metabolic and inflammatory changes could be an important triggering factor in the etiology of NL.

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Section: Discussionsupporting

confidence: 87%

Necrobiosis lipoidica: Clinical and Immunofluorescent Study

Laukkanen¹,

Fräki²,

Väätäinen³

et al. 1986

Dermatology

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“…Skin atrophy occurs rather rarely, but in our case the absence of radiological abnormalities excluded sarcoidosis from the differential diagnosis. In the early form of necrobiosis lipoidica, superficial annular lesions can resemble granuloma annulare, as in our case [12]. These data indicate that the diagnosis of NL is time consuming.…”

Section: Discussionsupporting

confidence: 59%

“…Necrobiosis lipoidica also has a sex predilection, being three times more common in women than in men [11]. One of the main problems with NL is its clinical similarity to other skin conditions: morphea, sarcoidosis and granuloma annulare [12]. Both morphea and NL can present as isolated yellow patches on sclerotic skin, but NL can be distinguished from morphea by telangiectasias around the lesions.…”

Section: Discussionmentioning

confidence: 99%

Necrobiosis lipoidica – an old but challenging dermatosis

Ciążyńska¹,

Bednarski²,

Woźniacka³

et al. 2016

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Introduction. Necrobiosis lipoidica (NL) is a rare skin condition associated with diabetes that occurs in 0.3-1% of diabetic patients. Nevertheless, there are patients who develop this entity in the absence of diabetes mellitus. Objective. To highlight some problems in differential diagnosis and treatment of NL. Case report. We report a case of a 44-year-old woman with a 3-year history of undiagnosed skin lesions. Clinical examination revealed atrophic plaques on an erythemal background located on both shins. The first histopathological examination revealed infiltrated granulomatous lesions, later confirmed as deep tuberculoides chronic granulomatous dermatitis. However, after 6-month anti-tubercular treatment skin lesions were still present. Based on another skin biopsy we restricted the diagnosis to polyarteritis nodosa, necrobiosis lipoidica and granuloma annulare. Further examination led us to establish a diagnosis of necrobiosis lipoidica. The patient was treated with many therapeutic regimens without a satisfactory response. Conclusions. Lack of treatment guidelines and therapy based on dermatologists' clinical experience suggest that NL needs to be evaluated in the near future. A large retrospective study and systematic review are required to establish diagnostic and treatment regimens. streszczenie Wprowadzenie. Obumieranie tłuszczowate (necrobiosis lipoidica -NL) jest rzadką dermatozą współwystępującą w 0,3-1% z cukrzycą, jednak obecność cukrzycy nie jest obligatoryjna. Cel pracy. Podkreślenie problemów w diagnostyce różnicowej i leczeniu NL. Opis przypadku. Przedstawiamy przypadek 44-letniej kobiety, u któ-rej zmiany skórne pozostawały nierozpoznane przez 3 lata. W badaniu przedmiotowym stwierdzono zanikowe zmiany na podłożu rumieniowym zlokalizowane na obu podudziach. Pierwsze badanie histopatologiczne wykazało nacieczone, ziarniniakowate zmiany o charakterze dermatitis chronica granulomatosa profunda tuberculoides, jednak 6-miesięczne leczenie przeciwgruźlicze nie przyniosło rezultatów. Na podstawie kolejnych badań histopatologicznych zawężono diagnozę do guzkowego zapalenia tętnic, NL i ziarniniaka obrączkowatego. Po po-

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Necrobiotic Disorders

Bs²,

Dermatologist³

2010

Rook's Textbook of Dermatology

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Necrobiosis lipoidica and granuloma annulare. Simultaneous occurrence in a patient

Cited by 7 publications

References 0 publications

Necrobiosis lipoidica: Clinical and Immunofluorescent Study

Necrobiosis lipoidica: Clinical and Immunofluorescent Study

Necrobiosis lipoidica – an old but challenging dermatosis

Necrobiotic Disorders

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