Hyperkeratotic necrobiosis lipoidica

An atypical case of papular necrobiosis lipoidica masquerading as sarcoidosis

“…There also are reports of papules developing within—or in conjunction with—the classic atrophic plaques of NL. 1 This case illustrates that dermatologists should consider this atypical variant of NL when faced with papular lesions localized to the anterior shins without systemic manifestations. If suspected, histopathologic confirmation should be sought, as early diagnosis can impact both prognosis and optimal treatment.…”

“…Necrobiosis lipoidica, first described by Oppenheim in 1929, 1 is a chronic granulomatous disorder. It is isolated to the lower legs in 85% of cases but in 15% of cases may involve other locations such as the abdomen, upper extremities, or scalp.…”

“… 3 It more commonly affects females, with a female/male ratio of 3 to 1. 1 Classic lesions are telangiectatic yellow-brown atrophic plaques. The lesions can resolve spontaneously or can persist and ulcerate in 15% of cases.…”