Necrobiosis lipoidica diabeticorum: A case-based review of literature

Kota, Sunil Kumar; Jammula, Sruti; Kota, Siva Krishna; Meher, Lalit Kumar; Modi, Kirtikumar D

doi:10.4103/2230-8210.98023

Cited by 43 publications

(55 citation statements)

References 52 publications

(56 reference statements)

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“…[137] The Geriatric Depression Scale is used to screen for depressive symptoms in older individuals. Validated diabetes-specific psychological instruments are also available that can be used in diabetes management[1546] (Grade A; EL 1).…”

Section: Psychiatric Assessmentmentioning

confidence: 99%

National recommendations: Psychosocial management of diabetes in India

Kalra

Sridhar

Balhara

et al. 2013

Indian J Endocr Metab

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Although several evidence-based guidelines for managing diabetes are available, few, if any, focus on the psychosocial aspects of this challenging condition. It is increasingly evident that psychosocial treatment is integral to a holistic approach of managing diabetes; it forms the key to realizing appropriate biomedical outcomes. Dearth of attention is as much due to lack of awareness as due to lack of guidelines. This lacuna results in diversity among the standards of clinical practice, which, in India, is also due to the size and complexity of psychosocial care itself. This article aims to highlight evidence- and experience-based Indian guidelines for the psychosocial management of diabetes. A systemic literature was conducted for peer-reviewed studies and publications covering psychosocial aspects in diabetes. Recommendations are classified into three domains: General, psychological and social, and graded by the weight they should have in clinical practice and by the degree of support from the literature. Ninety-four recommendations of varying strength are made to help professionals identify the psychosocial interventions needed to support patients and their families and explore their role in devising support strategies. They also aid in developing core skills needed for effective diabetes management. These recommendations provide practical guidelines to fulfill unmet needs in diabetes management, and help achieve a qualitative improvement in the way physicians manage patients. The guidelines, while maintaining an India-specific character, have global relevance, which is bound to grow as the diabetes pandemic throws up new challenges.

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Section: Psychiatric Assessmentmentioning

confidence: 99%

National recommendations: Psychosocial management of diabetes in India

Kalra

Sridhar

Balhara

et al. 2013

Indian J Endocr Metab

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“…As lesões são geralmente múltiplas e bilaterais, atingindo classicamente e simetricamente as regiões pré-tibiais (>80% dos casos) [1]. Raramente atinge os membros superiores, a face e o couro cabeludo [2,4,6].…”

Section: Discussionunclassified

“…Inicia-se aproximadamente aos 30 anos de idade, sendo mais precoce em diabéticos e mais frequente no sexo feminino. São raros os casos descritos em idade pediátrica [1][2][3][4][5][6].…”

Section: Introductionunclassified

Necrobiose lipoídica em adolescente com diabetes mellitus tipo 1: relato de caso

Gomes

Laranjo

Campos

et al. 2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. ABSTRACTAIMS: To report a case of necrobiosis lipoidica, a rare chronic granulomatous dermatosis. CASE DESCRIPTION: We present the case of a 17-year-old male adolescent, with type 1 diabetes mellitus from the age of four, followed in the Pediatric-Diabetology clinics of a level II hospital, under intensive regimen with multiple insulin administrations and poor metabolic control. At the age of 15, he noticed the appearance of an asymptomatic, erythematous, infiltrated, oval-shaped plaque, with a waxy whitish center, well-defined borders, 5 cm in diameter and progressive growth, located on the left forearm. The histological examination confirmed the diagnosis of necrobiosis lipoidica. He was treated with topical corticosteroid and emollient, thus stabilizing and reducing lesion infiltration. CONCLUSIONS: The authors highlight a rare dermatosis, non-pathognomonic of diabetes mellitus but related to this diagnosis in most cases. Its challenging recognition, especially in the presence of recent onset lesions, with atypical clinical presentation or in unusual sites, is fundamental in order to avoid erroneous or late treatments and its progression to ulceration.

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“…18 A neutrophil-predominant inflammatory infiltrate can be seen in the early stages of the disease. 3 …”

Section: Neutrophil Defectsmentioning

confidence: 99%

“…2 If patients have diabetes, optimization of glucose should be a goal for overall care of the patients; however, it should be in conjunction with other treatments. 18 Additional lifestyle modifications, including smoking cessation and avoidance of trauma, are equally important to minimize the risk of complications and promote healing. 1,39 Venous disease or lymphedema may complicate NL, especially when ulcerated.…”

Section: Evaluation and Managementmentioning

confidence: 99%