No abstract available.
Cyclosporine ; Necrobiosis Lipoidica ; Necrobiotic Disorders

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 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

Necrobiotic xanthogranuloma (NXG) is a rare, progressive, histiocytic disease characterized by destructive cutaneous lesions, a close association with paraproteinemia, multiple myeloma, hypertension, and multiple extracutaneous manifestations. Multiple indurated yellow-red plaques or nodules are commonly present in this disorder. The pathogenesis of NXG is poorly understood. Histopathologically, NXG features with hyaline necrosis or necrobiosis are present. We describe a patient with typical cutaneous and histologic findings of NXG with an associated monoclonal gammopathy.
Humans ; Hyalin ; Hypertension ; Multiple Myeloma ; Necrobiotic Disorders ; Necrobiotic Xanthogranuloma ; Necrosis ; Paraproteinemias

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

Necrobiotic xanthogranuloma (NXG) is a rare multisystemic disease that manifests as cutaneous inflammatory lesions and has a strong association with paraproteinemia and an increased risk of plasma cell dyscrasias and other lymphoproliferative disorders. Its general skin manifestation is multiple, asymptomatic, indurated nodules or plaques with a yellowish hue which frequently affect the periorbital regions. This case is unusual in that cutaneous lesions developed only at the extremities without periorbital involvement, accompanied by multiple myeloma.
Extremities ; Lymphoproliferative Disorders ; Multiple Myeloma* ; Necrobiotic Xanthogranuloma* ; Paraproteinemias ; Skin Manifestations

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

A 29-year-old woman had multiple, umbilicated papules on her fingers for 2 months. Skin biopsy specimen showed transepidermal perforation filled with plug of cellular debris, degenerated collagen and mucinous material. In the dermis, there were necrobiosis and peripheral palisading of mononuclear cells. Special stainings including masson's trichrome, alcian blue, acid orcein, and PAS showed necrobiotic collagen fibers and acid mucopolysaccharides on the necrobiotic zone and trasepidermal elimination canal. Topical application of 0.05% Clobetasol-17-propionate ointment improved her lesion.
Adult ; Alcian Blue ; Biopsy ; Collagen ; Dermis ; Female ; Fingers ; Glycosaminoglycans ; Granuloma Annulare* ; Granuloma* ; Humans ; Mucins ; Necrobiotic Disorders ; Skin

The isomorphic response of Koebner is a well-known phenomenon commonly associated with psoriasis, but it has been also described in conjuction with a host of other disorders. However it has seldom been associated with necrobiosis lipoidica diabeticorum, a rare skin manifestation of diabetes mellicuts. In this report, we describe a 59-year-old woman who developed necrobiosis lipoidica diabeticorum on the left shin where a mosquito had bitten her 2 months ago. Four months ago, she was diagnosed as necrobiosis lipoidica diabeticorum on the right forearm and shin by biopsy and the lesions were improved with corticosteroids intralesional injection. The lesions were asymptomatic and had grown slowly. Histopathological findings showed a large palisading granulomas composed of histiocytes, epithelioid cells and areas of necrobiosis of collagen with multinucleated giant cells. Van Gieson stain showed decreased and fragmented elastic fibers and there were no deposits of mucin in the necrobiotic areas. The lesions were improved with triamcinolone acetonide intralesional injection and there was no recurrence during 4 months.
Adrenal Cortex Hormones ; Biopsy ; Collagen ; Culicidae ; Elastic Tissue ; Epithelioid Cells ; Female ; Forearm ; Giant Cells ; Granuloma ; Histiocytes ; Humans ; Injections, Intralesional ; Middle Aged ; Mucins ; Necrobiosis Lipoidica* ; Necrobiotic Disorders* ; Psoriasis ; Recurrence ; Skin Manifestations ; Triamcinolone Acetonide