Squamous cell carcinoma developing in necrobiosis lipoidica

Imtiaz, Komal; Khaleeli, A. A.

doi:10.1046/j.1464-5491.2001.00452.x

Cited by 42 publications

(28 citation statements)

References 10 publications

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“…In this respect, most of our patients showed a lack of compliance or adherence, despite the psychological strain caused by the cosmetically disfiguring ulcerations and the pain. In addition, regular follow-up is necessary because it has been shown that long-standing chronic ulcerating lesions of necrobiosis lipoidica can lead to squamous cell carcinoma owing to malignant transformation as described in several case reports (28)(29)(30). In addition, an adequate pain therapy is necessary, because all patients in our group described their ulcerations as very painful.…”

Section: Treatmentmentioning

confidence: 90%

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Franklin

Stoffels-Weindorf

Hillen

et al. 2013

International Wound Journal

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Necrobiosis lipoidica is a rare granulomatous disorder of the skin. In up to 30% of the affected patients it can lead to ulcerations, which can impair the quality of life and are also very difficult to treat. Its pathogenesis is not fully understood. Only few studies focussing on necrobiosis lipoidica can be found, but none of them focus on ulcerated necrobiosis lipoidica. Therefore, we collected demographic data and comorbidities and assessed treatment options for patients with ulcerated necrobiosis lipoidica. Data of patients who were treated in the wound care centre of the University Hospital of Essen for ulcerated necrobiosis lipoidica over the past 10 years were retrospectively analysed. Hence, data of altogether ten patients (nine women and one man) with ulcerated necrobiosis lipoidica were collected. Of these, 70% of the patients had diabetes mellitus of which 30% had type I diabetes and 40% had type II diabetes; 60% of the patients suffered from arterial hypertension, obesity and hypercholesterolaemia; 40% of the patients suffered from psychiatric disorders such as depression and borderline disorder. Our clinical data demonstrate an association of ulcerated necrobiosis lipoidica and aspects of metabolic syndrome. This leads to a conclusion that ulcerating necrobiosis lipoidica can be seen as part of a generalised inflammatory reaction similar to the inflammatory reaction already known in the pathophysiology of rheumatoid diseases or psoriasis. In patients with clinical atypical painful ulcerations, necrobiosis lipoidica should be considered as a possible differential diagnosis. Therapists should be aware of associated aspects in patients with ulcerated necrobiosis lipoidica who besides diabetes often suffer from other aspects of a metabolic syndrome with increased cardiovascular risk factors. Therefore, these related comorbidities should also be diagnosed and treated.

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Section: Treatmentmentioning

confidence: 90%

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Franklin

Stoffels-Weindorf

Hillen

et al. 2013

International Wound Journal

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“…The immune complex deposition along with enhanced platelet aggregation and coagulation plays a role. [9]An additional etiologic theory focuses on the abnormal collagen in NLD. Defective and abnormal collagen fibrils are established cause of diabetic end-organ damage and accelerated aging.…”

Section: Discussionmentioning

confidence: 99%

“…The immune complex deposition along with enhanced platelet aggregation and coagulation plays a role. [9]…”

Section: Discussionmentioning

confidence: 99%

Necrobiosis lipoidica diabeticorum: A case-based review of literature

Kota¹,

Jammula²,

Kota³

et al. 2012

Indian J Endocr Metab

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Necrobiosis lipoidica diabeticorum (NLD) is a rare chronic and granulomatous skin disorder that affects 0.3% of diabetic patients. Although the etiology and pathogenesis of NLD is still controversial, it is thought that microangiopathy has an important role. The legs are the most common site for NLD, but involvement of other areas such as the abdomen, upper extremities and scalp has been reported. There is no rational therapy. However, benefit has been reported from different treatment regimens such as drugs acting on the hemostatic mechanisms, corticosteroid therapy (topical, intralesional and systemic), enhancers of wound healing, surgery and immunomodulating therapies (including photochemotherapy). We report a 59-year-old female, who was a diabetic patient with multiple, disseminated lesions on the legs, which tended to disappear as the glycemic control was achieved. Hereby, we also review the existing literature for the evolving aspects of etiopathogenesis and treatment.

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“…Trente-cinq pour cent des patients atteints de NLD déve-lopperont des ulcérations [1]. Une NLD ancienne, comme nombre d'affections cutanées chroniques, peut se transformer en un épithélioma malpighien de la peau comme le décrivent certains auteurs [1,[9][10][11]. La biopsie des lésions de la NLD montre habituellement un épiderme normal excepté lorsqu'il y a ulcération, auquel cas, ce dernier peut être atrophié, voire absent.…”

Section: Discussionunclassified