Necrobiosis Lipoidica
نویسندگان
چکیده
Background: In 1929, Oppehhein first described necrobiosis lipoidica diabeticorum and called it dermatitis atrophicans lipoidica diabetica, but it was later renamed necrobiosis lipoidica diabeticorum (NLD) by Urbach in 1932. In 1935, Goldsmith reported the first case in a nondiabetic patient. Other cases of NLD in nondiabetic patients were described by Meischer and Leder in 1948. Rollins and Winkelmann in 1960 also described this condition in nondiabetic patients, and a renaming of this disorder was suggested to exclude diabetes from the title. Today, the term necrobiosis lipoidica (NL) is used to encompass all patients with the same clinical lesions regardless of whether or not diabetes is present. Pathophysiology: NL is a disorder of collagen degeneration with a granulomatous response, thickening of blood vessel walls, and fat deposition. The exact cause of NL is unknown, but the leading theory of NL has focused on diabetic microangiopathy. Other theories suggest trauma or inflammatory or metabolic changes. Still other theories suggest that an antibody-mediated vasculitis may cause the changes seen in NL. Frequency: In the US: NL has been described in about 0.3% of diabetic patients. In one study, NL was shown to precede the onset of diabetes mellitus in 15% of patients. In addition, 60% of patients had the diagnosis of diabetes mellitus prior to the onset of NL, while 25% of patients had lesions that appeared with the onset of diabetes mellitus. The presence or progression of NL does not correlate with how well the diabetes is controlled. Mortality/Morbidity: Treatment for NL is not very satisfactory. The disease is typically chronic with variable progression and scarring. Squamous cell cancers have been reported in older lesions of NL related to previous trauma and ulceration. Race: NL has been reported to occur in all races with no predilection. Sex: NL is 3 times more common in women than in men. Age: The average age of onset is 30 years, but it can occur at any age. The age of onset ranges from infancy to the eighth decade. NL tends to develop at an earlier age in patients with diabetes.
منابع مشابه
Perforating necrobiosis lipoidica
Perforating necrobiosis lipoidica (PNL) is a very rare variant of necrobiosis lipoidica (NL), almost always associated with diabetes. A non-diabetic 43-year-old man referred to us with a gradually enlarging plaque on his forehead. The patient was initially diagnosed with cutaneous tuberculosis based on the histopatholo
متن کاملSimultaneous occurrence of ulcerated necrobiosis lipoidica and granuloma annulare in a patient - Case report * Ocorrência simultânea de necrobiose lipoídica ulcerada e granuloma anular em um paciente - Relato de caso
Simultaneous occurrence of granuloma annulare and necrobiosis lipoidica is quite rare. There are seven reported cases in the literature, but only one presenting ulcerated necrobiosis lipoidica. We report a 39-year-old male with histopathologically confirmed granuloma annulare and ulcerated necrobiosis lipoidica, without diabetes mellitus.
متن کاملNecrobiosis Lipoidica Diabeticorum of the Scalp: A Case Report
Necrobiosis lipoidica diabeticorum (NLD) is a rare chronic and granulomatous skin disorder that affects 0.3% of diabetic patients. Although the etiology and pathogenesis of NLD is still contraversial, it is thought that microangipathy has an important role. The legs are the most common site for NLD, but involvement of other areas such as the abdomen, upper extremities and scalp have been report...
متن کاملRisk factors for necrobiosis lipoidica in Type 1 diabetes mellitus.
AIMS To compare the clinical and metabolic characteristics of patients with Type 1 diabetes and necrobiosis lipoidica with those of patients with Type 1 diabetes who do not have necrobiosis lipoidica. A multicentre analysis was performed. METHODS Clinical and laboratory data were obtained from 64 133 patients (aged 0-25 years) with Type 1 diabetes with and without necrobiosis lipoidica who we...
متن کاملSimultaneous occurrence of ulcerated necrobiosis lipoidica and granuloma annulare in a patient: case report.
Simultaneous occurrence of granuloma annulare and necrobiosis lipoidica is quite rare. There are seven reported cases in the literature, but only one presenting ulcerated necrobiosis lipoidica. We report a 39-year-old male with histopathologically confirmed granuloma annulare and ulcerated necrobiosis lipoidica, without diabetes mellitus.
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