Necrobiosis lipoidica

    Article Contributors: 
    Sean Klepper M.D.
    Artur Zembowicz M.D....

    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.
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    Cases associated with this book:

  • Necrobiosis lipoidica diabeticorum
    Author: Antonios Kafanas M.D.

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

    Conference: Teaching Collection