Necrobiosis lipoidica

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Necrobiosis lipoidica is a necrotising skin condition that usually occurs in patients with diabetes mellitus but can also be associated with rheumatoid arthritis. In this first case it can be called necrobiosis lipoidica diabeticorum (NLD) . NLD occurs in about 0.3% of the diabetic population, with the majority suffering from women (about 3: 1 women for men affected).

The severity or control of diabetes in a person does not affect who will or will not get the NLD. Maintaining a better diabetes after being diagnosed with an NLD will not change how quickly NLD will solve it.

Video Necrobiosis lipoidica

Signs and symptoms

NL/NLD most often appears on the patient's shin, often on both legs, although it may also occur in the forearms, arms, stems, and, rarely, nipples, penises, and surgical sites. Lesions are often asymptomatic but can become tender and boils when injured. The first symptoms of NL are often the appearance of "bruises" (erythema) that are not always associated with known injuries. The extent to which NL is inherited is unknown.

NLD appears as an area of ​​hardened and raised skin. The center of the affected area usually has a yellowish color while the surrounding area is dark pink. There is a possibility that the affected area will spread or become an open wound. When this happens, the patient is at greater risk of ulcers. If a skin injury occurs in the affected area, it may not heal properly or will leave a dark scar.

Maps Necrobiosis lipoidica

Pathophysiology

Although the exact cause of this condition is unknown, it is an inflammatory disorder characterized by collagen degeneration, combined with a granulomatous response. It always involves the dermis diffusely, and sometimes also involves a deeper layer of fat. Generally, thickened dermal vessels (microangiopathy).

Can be triggered by local trauma, though often without injury.

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Diagnosis

NL was diagnosed with a skin biopsy, showing peripheral and superficial peripheral infertile infiltration of the peripheral and peripheral interstices (including lymphocytes, plasma cells, mononucleic and multinuclear mytiocytes, and eosinophils) in the dermis and subcutis, and necrotic necrosis with adjacent necrobiosis and necrosis. adnexal structure. The necrobiosis area is often wider and less well-defined than in the annulare granuloma. The presence of lipids in the necrobiotic region can be demonstrated by Sudan's stains. Cholesterol, fibrin, and mucin cleft can also be found in the necrobiosis area. Depending on the severity of necrobiosis, certain cell types may be more dominant. When the lesion is at an early stage, neutrophils may be present, whereas in later stages the lymphocytes and histiocyte development may be more dominant.

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Treatment

There is no clear cure for necrobiosis. NLD can be treated with PUVA therapy and improve therapeutic control.

Although there are several techniques that can be used to reduce signs of necrobiosis such as oral low-dose aspirin, steroid cream or injection to the affected area, this process may be effective for only a small proportion of those treated.

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See also

• diabetic dermadrome
• List of skin conditions

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References

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External links

• Information and images in NIH

Source of the article : Wikipedia