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Necrobiosis Lipoidica

Allison H Gase, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Necrobiosis lipoidica (NL) is a chronic granulomatous disease of the skin characterized by atrophic plaques typically located on the lower extremities.

  • Presents with red-brown papules...

DIAGNOSIS

HISTORY

  • Typically, presents unilaterally or bilaterally on the pretibial surface of lower extremities.

  • Lesions enlarge slowly from months to years.

  • Generally asymptomatic, but some lesions, esp...

TREATMENT

Numerous therapies have been tried. Unfortunately, there is little evidence supporting the use of one specific therapy over another. 

GENERAL MEASURES

  • Treatment is aimed at symptom management ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • In-office follow-up is recommended every three months to one year based upon the severity of the disease, the rate of disease progression, and the need for treatm...

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...

ADDITIONAL READING

Rajabi-Estarabadi A, Aickara DJ, Hirsch M, et al. Laser and light therapies for the treatment of necrobiosis lipoidica. Lasers Med Sci. 2021;36(3):497–506. ...

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

SNOMED

  • 9418005 Necrobio...

CLINICAL PEARLS

  • NL is a granulomatous skin disease.

  • Historically thought to be associated with DM, but it has been found in association with other diseases and in healthy individuals as well.

  • Initial tr...

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