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Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2006.
Necrobiosis lipoidica is a rare granulomatous skin disorder which can affect the shin of insulin-dependent diabetics, although it may occur in non-diabetic subjects as well. The cause is unknown.
Necrobiosis lipoidica is three to five times more common in females than in males.
Typically in necrobiosis lipoidica, one or more yellowish brown patches develop slowly on the lower legs over several months.
The diagnosis of necrobiosis lipoidica may be made clinically. A skin biopsy may be performed to confirm the diagnosis. The histopathology is characteristic; it shows a granulomatous inflammatory reaction around destroyed collagen. This is known as necrobiosis or collagenolyis. It can be difficult to distinguish from granuloma annulare and rheumatoid nodule.
Not all cases of necrobiosis lipoidica require treatment. The following treatments are sometimes effective:
Ulcerating necrobiosis lipoidica may require aggressive treatment.
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