Tuberous Necrobiosis Lipoidica

The granulomatous reaction pattern

“…436 Cases of the non-necrobiotic sarcoidal or tuberculoid type of granuloma annulare are uncommon and pose a diagnostic problem. 458 Some lesions resolve spontaneously but many are persistent and chronic and may ulcerate; [459][460][461] this occurred in 13% of cases in one series. 7.11).…”

“…Unusual sites include the nipple, penis, surgical scars, and a lymphedematous arm. 458,491 Fibrin can also be demonstrated in necrobiotic areas. Lesions may be single but are more often multiple.…”

Hyperkeratotic necrobiosis lipoidica

“…Perforating necrobiosis lipoidica is rare and only a few cases have been described in the literature [9–13]. Michaels and Mullinax et al reported a case of tuberous necrobiosis lipoidica in which they observed yellow nodules, reminiscent of tuberous xanthomas, superimposed on patches of necrobiosis lipoidica [14]. These nodules eventually coalesced and grew more nodular and verrucous over time.…”

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

“…Classic, well‐developed lesions of NL feature patches or plaques with an atrophic, slightly depressed, often shiny yellow–brown center . The border of these lesions frequently demonstrates a well‐defined inflammatory edge that may be raised and red to purple in color . The pretibial areas are the most commonly affected location, and less frequently lesions may be seen on the upper extremities, face, and scalp.…”

“…1 The border of these lesions frequently demonstrates a well-defined inflammatory edge that may be raised and red to purple in color. 1,2 The pretibial areas are the most commonly affected location, and less frequently lesions may be seen on the upper extremities, face, and scalp. Up to 35% of cases demonstrate ulceration, frequently following minor trauma.…”