Necrobiosis lipoidica in a non-diabetic female with extensive vitiligo: An uncommon association

Abstract

Necrobiosis lipoidica diabeticorum (NLD) is a chronic non-infectious granulomatous disease characterized by sclerodermiform plaques, papules, or inflammatory nodules. NLD may be associated with diabetes mellitus (DM), sarcoidosis, rheumatoid arthritis, and inflammatory bowel disease. While reports of patients having NLD, DM, and vitiligo at the same time exist, there are, to the best of our knowledge, no reports of the cooccurrence of NLD and vitiligo in the absence of evidence of DM. Herein, we report a 57-year-old, non-diabetic vitiligo patient, who had developed yellowish-brown plaques over bilateral shins with central scarring and atrophy. Histopathology was compatible with NLD. While there is a case report of a patient having psoriasis, NLD, DM, and vitiligo concurrently, this case, having NLD and vitiligo without clinically evident DM, is prominent. Since around 20–40% of cases of vitiligo may have metabolic syndrome, this case draws attention to the possible overlap in pathogeneses and the need for the intensive monitoring of such patients.