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Necrobiosis Lipoidica

Rasheen Syeda Imtiaz, MD and Jarad Levin, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Necrobiosis lipoidica (NL) is a granulomatous skin disease.

  • Presents with red-brown papules that develop into plaques with violaceous or red-brown raised borders and atrophic, yellow-...

DIAGNOSIS

HISTORY

  • Lesions enlarge slowly from months to years.

  • Generally asymptomatic but some lesions, especially when ulcerated, may be painful and/or pruritic

  • Ulceration occurs in up to 1/3 of cases, ...

TREATMENT

GENERAL MEASURES

  • Treatment is aimed at symptom management and controlling inflammation, although the best treatment remains controversial.

  • Observation may be reasonable for initial management ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • In-office follow-up recommended

  • Evaluate for concurrent peripheral arterial and venous disease depending on clinical suspicion, and counsel for smoking cessation b...

REFERENCES

1
Reid SD, Ladizinski B, Lee K, et al. Update on necrobiosis lipoidica: a review of etiology, diagnosis, and treatment options. J Am Acad Dermatol.  2013;69(5):783–791. [View Abstract o...

ADDITIONAL READING

Feily A, Mehraban S. Treatment modalities of necrobiosis lipoidica: a concise systematic review. Dermatol Reports.  2015;7(2):5749. [View Abstract on OvidMedline] 

CODES

ICD10

  • L92.1 Necrobiosis lipoidica, not elsewhere classified

  • E10.620 Type 1 diabetes mellitus with diabetic dermatitis

  • E11.620 Type 2 diabetes mellitus with diabetic dermatitis

ICD9

  • 709.3 Degenerative...

CLINICAL PEARLS

  • NL is a granulomfatous skin disease.

  • Historically thought to be associated with DM, but this association has been questioned in recent literature; it has been found in association with ...

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