Recurrent necrobiosis lipoidica diabeticorum associated with venous insufficiency in an adolescent with poorly controlled type 2 diabetes mellitus

Yigit, Sevket; Estrada, Elizabeth

doi:10.1067/mpd.2002.126302

Cited by 12 publications

(15 citation statements)

References 8 publications

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“…There are reported associations with necrobiosis lipoidica and chronic venous insufficiency as well as hypercholesterolaemia. It has been discussed that both can trigger necrobiosis lipoidica and tissue damage (10,11).…”

Section: Pathophysiologymentioning

confidence: 99%

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Franklin

Stoffels-Weindorf

Hillen

et al. 2013

International Wound Journal

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Necrobiosis lipoidica is a rare granulomatous disorder of the skin. In up to 30% of the affected patients it can lead to ulcerations, which can impair the quality of life and are also very difficult to treat. Its pathogenesis is not fully understood. Only few studies focussing on necrobiosis lipoidica can be found, but none of them focus on ulcerated necrobiosis lipoidica. Therefore, we collected demographic data and comorbidities and assessed treatment options for patients with ulcerated necrobiosis lipoidica. Data of patients who were treated in the wound care centre of the University Hospital of Essen for ulcerated necrobiosis lipoidica over the past 10 years were retrospectively analysed. Hence, data of altogether ten patients (nine women and one man) with ulcerated necrobiosis lipoidica were collected. Of these, 70% of the patients had diabetes mellitus of which 30% had type I diabetes and 40% had type II diabetes; 60% of the patients suffered from arterial hypertension, obesity and hypercholesterolaemia; 40% of the patients suffered from psychiatric disorders such as depression and borderline disorder. Our clinical data demonstrate an association of ulcerated necrobiosis lipoidica and aspects of metabolic syndrome. This leads to a conclusion that ulcerating necrobiosis lipoidica can be seen as part of a generalised inflammatory reaction similar to the inflammatory reaction already known in the pathophysiology of rheumatoid diseases or psoriasis. In patients with clinical atypical painful ulcerations, necrobiosis lipoidica should be considered as a possible differential diagnosis. Therapists should be aware of associated aspects in patients with ulcerated necrobiosis lipoidica who besides diabetes often suffer from other aspects of a metabolic syndrome with increased cardiovascular risk factors. Therefore, these related comorbidities should also be diagnosed and treated.

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Section: Pathophysiologymentioning

confidence: 99%

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Franklin

Stoffels-Weindorf

Hillen

et al. 2013

International Wound Journal

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“…Cells in the basal layer destined to form keratin are distinguished by the presence of keratin filaments and are known as keratinocytes. [13][14][15][16][17] However, histological studies [16][17][18] of diabetic changes in mucosal tissues, especially the gingiva, have been inconclusive. 5 Keratin produced by keratinocytes fills intercellular spaces, and normally prevents the loss of tissue fluids into the oral cavity.…”

mentioning

confidence: 99%

Comparison of Keratinocyte Proliferation in Diabetic and Non‐Diabetic Inflamed Gingiva

Açikgoz

Devrim

Özdamar

2004

Journal of Periodontology

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“…Skin conditions related to venous insufficiency, including sclerosing panniculitis and stasis ulcer, are commonly seen in lower extremities. Some reports have also suggested that there is a relationship between venous insufficiency and NL 7,8 . As all our four cases had venous insufficiency and hypercholesterolemia, we presumed that both hyperlipidemia and venous reflux, in addition to other pathogenic factors, triggered tissue damage in the lower legs to lead the onset and the refractory clinical course of NL.…”

Section: Discussionmentioning

confidence: 52%

Venous insufficiency in patients with necrobiosis lipoidica

Nakajima¹,

Tanemura

Inui³

et al. 2009

The Journal of Dermatology

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The pretibial area is the most frequently affected site in necrobiosis lipoidica (NL), but proposed mechanisms of NL cannot fully explain this high frequency. Although a few case reports indicate NL patients are complicated with venous insufficiency, no accurate assessment of the relationship between these two conditions has been performed. By using color Doppler ultrasonographic screening of four NL patients for venous insufficiency, we detected venous insufficiency in at least one leg of each patient. NL lesions were observed on all legs with venous insufficiency, and laboratory examination findings revealed that all the patients had hypercholesterolemia. The skin lesions did not respond satisfactorily to 6-month use of anticholesterolemic medication and elastic stockings. However, these results indicate that both hyperlipidemia and venous reflux, in addition to other pathogenic factors, can trigger tissue damage in the lower legs and lead to the onset of NL.

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Recurrent necrobiosis lipoidica diabeticorum associated with venous insufficiency in an adolescent with poorly controlled type 2 diabetes mellitus

Cited by 12 publications

References 8 publications

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Comparison of Keratinocyte Proliferation in Diabetic and Non‐Diabetic Inflamed Gingiva

Venous insufficiency in patients with necrobiosis lipoidica

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