Necrobiosis lipoidica diabeticorum is a rare disease and possibly confused with another conditions such as sarcoid disease, rheumatic pimple … In its histopathological study, it must consider the histochemical methods in detecting the damage of connective fiber tissues as well as clinical signs of the disease. The gender ratio is 1/3 (male/female), the mean age of onset is 30 years old. The necrotic lipoid tissue can occur in various areas – thigh, leg, foot, hand and head skin, most commonly in the right face of the leg
diagnosis ; Necrobiosis Lipoidica ; Therapeutics

No abstract available.
Cyclosporine ; Necrobiosis Lipoidica ; Necrobiotic Disorders

Necrobiosis Lipoidica is a skin disorder of unknown cause, which shows characteristic clinical and histological findings. With histochemical studies, we report of a case which oecurred on the both pretibial surfaces in a 5]-year-old female. Having had treatment with aspirin and dipyridarnole for 9 months. The results were successful.
Aspirin ; Female ; Humans ; Necrobiosis Lipoidica* ; Necrobiotic Disorders* ; Skin

Transepidermal elimination is a mechanism whereby foreign or altered constituents can be removed from the dermis. The phenomenon of transepidermal elimination may occur as a primary process characterizing disorders such as elastosis perforans serpiginosa, reactive perforating collagenosis and chondrodermatitis nodularis chronica helicis; as well as a secondary process characterizing disorders such as granuloma annulare, necrobiosis lipoidica diabeticorum, calcinosis cutis, pseudoxanthoma elasticum, spitz nevi, pimented nevi, porokeratosis plantaris discreta and metastatic tumors. A 17-year-old man presented with a 2X2 cm sized well-circumscribed slightly erythematous plaque with some black colored papules on the left dorsum of his hand. The histopathology of the lesion indicated angiokeratoma circumscriptum with transepidermal elimination.
Adolescent ; Angiokeratoma* ; Calcinosis ; Dermis ; Granuloma Annulare ; Hand ; Humans ; Necrobiosis Lipoidica ; Nevus ; Porokeratosis ; Pseudoxanthoma Elasticum

A 70-year-old woman with an 8-year history of systemic sarcoidosis developed round, red-brown eruptions, with central atrophic lesions on her lower legs. The features of the biopsy specimen resembled those of necrobiosis lipoidica (NL), but although necrobiosis was present there were well-formed non-necrotizing granulomas in the dermis. The histological diagnosis was cutaneous sarcoidosis. Systemic sarcoidosis presenting with NL has rarely been reported. The histological features of cutaneous sarcoidosis sometimes mimic those of other granulomatous diseases, including NL and granuloma annulare, which are difficult to distinguish. We discuss the novel association between sarcoidosis and other granulomatous diseases.
Aged ; Biopsy ; Dermis ; Female ; Granuloma ; Granuloma Annulare ; Humans ; Hydrazines ; Leg ; Necrobiosis Lipoidica ; Necrobiotic Disorders ; Sarcoidosis

We report an unusual case of necrobiosis lipoidica with prominent cholesterol clefts in a 36-year-old man who had developed multiple, 0.5~5cm in diameter, round to oval-shaped erythematous plaques on both shins for over 3 years. Laboratory findings showed the following; cholesterol, 250mg/dl; triglyceride, 208mg/dl; blood sugar level fasting/2-h postprandial, 101/92mg/dl; and other findings were within normal limits or negative. There was no paraproteinemia. The biopsy specimen showed various lymphohistiocytic granuloma with many giants cell in the mid and deep dermis, and septal fibrosis in the subcutaneous tissue. There were also extensive areas of necrobiosis with prominent cholesterol clefts mimicking necrobiotic xanthogranuloma.
Adult ; Biopsy ; Blood Glucose ; Cholesterol* ; Dermis ; Fibrosis ; Granuloma ; Humans ; Necrobiosis Lipoidica* ; Necrobiotic Disorders* ; Necrobiotic Xanthogranuloma ; Paraproteinemias ; Subcutaneous Tissue ; Triglycerides

Necrobiosis lipoidica (NL) is a chronic granulomatous skin disease of unknown etiology, which can be seen in patients with diabetes mellitus. Typical lesions of NL appear on the pretibial skin as painful yellow-brown inflammatory plaques with raised borders and atrophic centers. Ulceration occurs in approximately 35% of cases, leading to increased risk of secondary bacterial infection and scarring. Although there have been many proposed therapies for ulcerative NL, the response to treatment is often met with limited success. Here, we report a case of a 19-year-old girl with ulcerative NL, which showed improvements with oral hydroxychloroquine, an antimalarial agent.
Bacterial Infections ; Cicatrix ; Diabetes Mellitus ; Humans ; Hydroxychloroquine ; Necrobiosis Lipoidica ; Necrobiotic Disorders ; Skin ; Skin Diseases ; Ulcer ; Young Adult

Necrobiosis lipoidica (NL) is a dermatologic disorder characterized by sharply demarcated yellow-brown plaques or indurated plaques with violaceous, irregular borders usually located on the pretibial region. Lesions may flatten and develop a central yellow or orange area as it becomes atrophic, often accompanied by the appearance of telangiectasias, giving it the characteristic "glazed¬porcelain" sheen. Typical histologic findings are seen at the edge of the lesions and include: variable amount of dermal fibrosis, particularly in its lower two-thirds of the dermis; and a superficial and deep perivascular inflammatory reaction. The dermal changes extend to the underlying subcutaneous septa. Although these histologic findings were first described in diabetic patients, not all patients with NL have concurrent diabetes. Treatment of NL involves the use of potent topical steroids and the prevention of the development of ulcers. This is a case of a 29-year-old female who presented with few erythematous plaques on the left anterolateral portion of the left lower extremity, histologically confirmed as NL with normal fasting blood sugar levels.

Human ; Female ; Adult ; Atrophy ; Blood Glucose ; Citrus Sinensis ; Connective Tissue Diseases ; Dermis ; Diabetes Mellitus ; Necrobiosis Lipoidica ; Skin Diseases ; Telangiectasis ; Ulcer

Necrobiosis lipoidica (NL) is a chronic granulomatous skin disease typified by indurated plaques on the shin. Although this condition is strongly associated with diabetes mellitus, its etiology and pathogenesis remains unknown. Localization of NL to the lower extremities suggests that local injury may be a contributing factor to the disease. A healthy 38-year-old man presented with localized erythematous to yellowish plaques on his right thigh that developed over several years. The lesion developed in the scar where suture had been done for laceration repair 25 years ago. A biopsy specimen showed degenerated collagen with surrounding palisading granulomas. Numerous lymphocytes and multinucleated giant cells were infiltrated throughout the reticular dermis. Plasma cells aggregation was found at the dermal subcutaneous junction.
Biopsy ; Cicatrix ; Collagen ; Dermis ; Diabetes Mellitus ; Giant Cells ; Granuloma ; Humans ; Lacerations ; Lower Extremity ; Lymphocytes ; Necrobiosis Lipoidica ; Necrobiotic Disorders ; Plasma Cells ; Skin Diseases ; Sutures ; Thigh

BACKGROUND: Membranocystic change represents a distinctive form of pathology in adipose tissue. It has been observed in a variety of inflammatory and noninflammatory dermatoses. OBJECTIVE: Our purpose was to find the clinical and histopathological features of membranocystic change in the panniculitis and we attempted to review the pathogenesis. METHODS: We reviewed medical records, clinical photographs, and histopatologic findings of 14 patients having membranocystic changes in biopsy specimen. RESULTS: (1) There was a female predominance (79%). (2) The most common primary lesions were the subcutaneous nodules and the most predilection sites were the lower legs. (3) The underlying diseases were variable such as erythema nodosum, lipoatrophy, sparganosis, sporotrichosis, accelerated nodulosis, necrobiosis lipoidica, periarteritis nodosa, tibial artery stenosis, dermatomyositis, lupus erythematosus profundus, oil granuloma and nodulocystic fat necrosis. (4)The membranes of cyst were positive with periodic acid-Schiff stain with diastase and sudan black B. Fluorescence examination gave a yellow autofluorescence. These findings indicated the lining materials were ceroid. CONCLUSION: Membranocystic change appears to be entirely nonspecific and may be seen in many types of the subcutaneous inflammatory process. Although ischemic insult has received the most attention in dermatologic literature as the primary cause, it is likely that this change results from various insults to adipose tissue, including infectious, autoimmune, and physical processes.
Adipose Tissue ; Amylases ; Biopsy ; Ceroid ; Constriction, Pathologic ; Dermatomyositis ; Erythema Nodosum ; Fat Necrosis ; Female ; Fluorescence ; Granuloma ; Humans ; Leg ; Medical Records ; Membranes ; Necrobiosis Lipoidica ; Panniculitis* ; Panniculitis, Lupus Erythematosus ; Pathology ; Physical Processes ; Polyarteritis Nodosa ; Skin Diseases ; Sparganosis ; Sporotrichosis ; Sudan ; Tibial Arteries