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Necrobiosis Lipoidica

Reviewed 06/2018
 


BASICS

DESCRIPTION

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

  • Presents with violaceous red–brown skin plaques with palpable borders and yellow–brown atrophic centers with telangiectasia...

DIAGNOSIS

HISTORY

  • Lesions enlarge slowly from months to years.

  • Decreased sensation to pinprick and fine touch

  • Ulceration occurs typically after trauma.

  • Lesions, especially when ulcerated, may be painful a...

TREATMENT

GENERAL MEASURES

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

  • Observation may be reasonable for initial management as t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • In-office follow-up recommended but no specific time interval is considered best

  • Evaluate for peripheral vascular disease, including ankle-brachial index, angiogra...

REFERENCES

1
Erfurt-Berge C, Seitz AT, Rehse C, et al. Update on clinical and laboratory features in necrobiosis lipoidica: a retrospective multicentre study of 52 patients. Eur J Dermatol.  2012;...

ADDITIONAL READING

  • Kota SK, Jammula S, Kota SK, et al. Necrobiosis lipoidica diabeticorum: a case-based review of literature. Indian J Endocrinol Metab.  2012;16(4):614–620.

  • Pătraşcu V, Giurcă C, ...

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 granulomatous skin disease associated with DM.

  • It is associated with abnormal glucose tolerance, but progression does not typically correlate with glucose control.

  • Initial treatm...

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