Also known as necrobiosis lipoidica diabeticorum

Clinical Features:

• Approximately two thirds of cases are associated with diabetes mellitus.
• Women are affected three times more frequently than men.
• Patients present with indurated, waxy patches or plaques surrounded by an erythematous border, most frequently on the shins.

Histologic Features:

• The dermis and subtimes subcutis show zones of degenerated collagen ("necrobiosis") alternating with palisading granulomatous inflammation.
• The areas of necrobiosis and granulomatous inflammation characteristically alternate in horizontal rows, parallel to the epidermis.
• Mucin is absent, in contrast to granuloma annulare.
• The dermis is diffusely involved, in contrast to the focal involvement normally seen in granuloma annulare.
• The adjecent dermis is typically fibrotic, unlike in granuloma annulare, in which it is normal.
• A superficial and deep perivascular inflammatory infiltrate rich in plasma cells is typically present, and there may be vasculitis.

Cases associated with this book:

Necrobiosis lipoidica diabeticorum
Author: Antonios Kafanas M.D.

clinical image

Necrobiosis lipoidica
Author: Artur Zembowicz M.D. Ph.D.

Conference: DermatopathologyConsultations.com Teaching Collection