Response of Ulcerated Necrobiosis Lipoidica to Clofazimine

Benedix, Frauke; Geyer, A; Lichte, V.; Metzler, Gisela; Röcken, Martin; Strölin, Anke

doi:10.2340/00015555-0722

Cited by 12 publications

(8 citation statements)

References 8 publications

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“…Reported treatment modalities include topical and intralesional corticosteroids, topical tacrolimus, and various immunosuppressive agents, including cyclosporine, methotrexate, and mycophenolate mofetil . Other therapies include clofazimine, antimalarial agents, and topical psoralen + ultraviolet A therapy . Additionally, successful treatment of NL has been reported with anti‐tumor necrosis factor (TNF) therapy, including etanercept and infliximab .…”

Section: Discussionmentioning

confidence: 99%

Necrobiosis lipoidica occurring in a patient with rheumatoid arthritis on concurrent tumor necrosis factor‐α inhibitor therapy

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Necrobiosis lipoidica occurring in a patient with rheumatoid arthritis on concurrent tumor necrosis factor‐α inhibitor therapy

et al. 2014

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“…Smoking cessation and diabetic control may also be effective; nevertheless, there is no correlation between disease activity and glycemic control [1]. Other treatments include systemic corticosteroids, topical tacrolimus [5], cyclosporine [6], mycophenolate mofetil [7], pentoxifylline [8], fumaric acid esters [9], clofazimine [10], antimalarial agents [11], topical psoralen-UVA [12], UVA1 phototherapy [13], photodynamic therapy [14] and excision and skin grafting [3]. …”

Section: Discussionmentioning

confidence: 99%

Necrobiosis Lipoidica Therapy with Biologicals: An Ulcerated Case Responding to Etanercept and a Review of the Literature

Suárez-Amor¹,

Pérez‐Bustillo²,

Ruíz‐González³

et al. 2010

Dermatology

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Necrobiosis lipoidica (NL) is an idiopathic chronic granulomatous skin condition. There is currently no standardized effective treatment of NL. Ulceration occurs in up to 35% of cases. Treatment of ulcerative lesions is challenging and often unsuccessful. On the basis of the implication of the tumor necrosis factor α (TNF-α) on the formation of granulomas, since 2003 anti-TNF-α agents have been employed in cases of NL refractory to other therapeutic agents. We report a 50-year-old white woman with treatment-resistant chronic ulcerative NL of both shins successfully treated with subcutaneous etanercept. A review of the published literature suggests that biological agents (etanercept and infliximab) should be considered as a therapeutic alternative mainly in ulcerative NL unresponsive to prior conventional regimens. The dose and duration of treatment with these agents is not defined, therefore it is required to report management of these patients in order to develop an optimal therapeutic strategy.

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“…Once ulceration has occurred in NL, it can be frustratingly difficult to heal. Therapeutic measures that have been utilized include topical, intralesional, or systemic corticosteroids; calcineurin inhibitors delivered topically (tacrolimus ) (also a gli‐1 inhibitor) or systemically (cyclosporine ); hydroxychloroquine ; clofazimine ; phototherapy including UVA1 and topical PUVA ; application of bioengineered human fibroblast‐derived dermal substitute material ; and a variety of agents that (among other biological activities) inhibit tumor necrosis factor‐alpha (TNF‐α): pentoxifylline , thalidomide , and the biologics etanercept and infliximab .…”

Section: Inflammatory Ulcersmentioning

confidence: 99%

Atypical ulcers

Hoffman

2013

Dermatol Ther

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Atypical ulcers of the skin challenge the dermatologist with respect to recognition, diagnosis, management, and treatment. The entire gamut of pathogenic categories including vascular, inflammatory, neoplastic, genetic, medication-related, and infectious processes may give rise to atypical ulcers. By definition, these ulcers are unusual, and accurate diagnosis may ultimately require the clinician to violate the dictum that "common things are common." Atypical ulcers may present with features that the clinician has not previously encountered, or may present with seemingly typical features that actually mislead due to phenotypic mimicry. Because skin ulcers are inherently tissue-destructive, and may reflect an underlying systemic disease process, there is heightened urgency to achieving an accurate diagnosis and initiating appropriate therapy.

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Response of Ulcerated Necrobiosis Lipoidica to Clofazimine

Cited by 12 publications

References 8 publications

Necrobiosis lipoidica occurring in a patient with rheumatoid arthritis on concurrent tumor necrosis factor‐α inhibitor therapy

Necrobiosis lipoidica occurring in a patient with rheumatoid arthritis on concurrent tumor necrosis factor‐α inhibitor therapy

Necrobiosis Lipoidica Therapy with Biologicals: An Ulcerated Case Responding to Etanercept and a Review of the Literature

Atypical ulcers

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