Necrobiosis lipoidica (NL) is a rare chronic inflammatory granulomatous skin disease, often associated with diabetes mellitus. We present the case of a 52-year-old Filipino female with a history of hypertension and well-controlled diabetes, who developed an ulcerated lesion on her right leg following an insect bite. Despite various self-medications and multiple treatments from different physicians, the ulcer persisted and progressed, leading to her referral for further evaluation. Histopathologic examination confirmed necrobiosis lipoidica. Initial treatment with topical corticosteroids and tacrolimus showed minimal improvement, prompting the use of punch grafting and platelet-rich plasma (PRP) injections. After six PRP sessions, the patient exhibited significant wound healing and a notable reduction in pain, leading to an improved quality of life. This case highlights the effectiveness of punch grafting and PRP injections in managing ulcerated NL, providing a novel therapeutic approach for a challenging condition.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Necrobiosis Lipoidica ; Ulcer

INTRODUCTION

Allergic contact dermatitis remains a commonly encountered condition in dermatology. Contact allergen prevalence fluctuates over time, making ongoing surveillance essential for detecting trends and identifying emerging allergens.

OBJECTIVE

To determine the prevalence and trends of top allergen patch test-positive patients over a 10-year period.

METHODS

The medical records of 906 patients who underwent patch testing at the hospital between 2012 and 2021 were retrospectively reviewed. Clinical data and patch tests results with clinical relevance from consultation records were extracted and analyzed.

RESULT

In the 10 years, data from 996 patients patch tested with European baseline series of contact allergens were analyzed. The overall positivity rate was 64.25%. The predominant allergens investigated during the previous decade include nickel sulfate (19.60%), fragrance mix I (8.70%), potassium dichromate (5.99%), cobalt chloride (5.92%), and p-phenylenediamine base (5.92%). The trend in our study aligns with global patch test data, with nickel sulfate consistently leading as the most frequent allergen.

CONCLUSION

The study emphasizes the need for regular monitoring and updating of the standard patch test series to ensure its clinical relevance and improve patient care.

Human ; Dermatitis, Allergic Contact ; Patch Tests ; Epidemiology