Update on necrobiosis lipoidica: A review of etiology, diagnosis, and treatment options

Reid, Sophia D.; Ladizinski, Barry; Lee, Kachiu C.; Baibergenova, Akerke; Alavi, Afsáneh

doi:10.1016/j.jaad.2013.05.034

Cited by 174 publications

(194 citation statements)

References 63 publications

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…The leading theory advocates that NL is a manifestation of microangiopathy resulting from glycoprotein deposition in blood vessel walls. 6,7 Similar vascular changes involving glycoprotein deposition occur in diabetic microangiopathy of other organs, such as the eye and kidney, yet other microvascular complications of diabetes are relatively frequent and there is no evidence to suggest a shared aetiology with NL. Hypoxia has been suggested to play a role in the pathogenesis, however evidence for this is conflicting.…”

Section: Aetiologymentioning

confidence: 99%

“…Hypoxia has been suggested to play a role in the pathogenesis, however evidence for this is conflicting. 7 Other possibilities include antibody-mediated vasculitis, collagen abnormalities, platelet aggregation, trauma, inflammatory and metabolic changes or a tumour necrosis factor mediated process. 6,8 The finding of Glut 1 (human erythrocyte glucose transporter) expression in areas of sclerotic collagen suggest a possible role for abnormal glucose transport by fibroblasts.…”

Section: Aetiologymentioning

confidence: 99%

“…6,7 They are usually painless, but may be exquisitely painful, especially if ulcerated (Figure 4). Lesions are most frequently located bilaterally on the lower extremities, but may occasionally occur at other sites ( Figure 5).…”

Section: Clinical Featuresmentioning

confidence: 99%

“…9 Squamous cell carcinomas have occasionally been reported to complicate longstanding lesions. 7,10,20,21,22 …”

Section: Clinical Featuresmentioning

confidence: 99%

“…Reid et al summarised the evidence for the various therapeutic approaches in a recent review. 7 Optimising glycaemic control does not alter progression of the lesions. Therapeutic strategies involve avoiding trauma to minimise the risk of ulceration and treating infections with antiseptics or antibiotics.…”

Section: Treatmentmentioning

confidence: 99%

See 4 more Smart Citations

Necrobiosis lipoidica

George

Walton

2015

Br J Diabetes

View full text Add to dashboard Cite

Necrobiosis lipoidica and granuloma annulare are granulomatous skin conditions that have been traditionally associated with diabetes mellitus, although recently the strength of association has been questioned. In the first section of this two-part article, we describe the suggested aetiology, clinical features, histology and treatment of necrobiosis lipoidica. It is found in 0.3% of patients with diabetes, but has also been reported with other systemic conditions. Clinically it appears as a waxy, atrophic, yellowish plaque with overlying telangiectasia and a brown border. Although usually asymptomatic, it may be extremely painful, especially if ulcerated. Squamous cell carcinoma has occasionally been reported with longstanding lesions. Treatment is often difficult: numerous topical and systemic agents have been employed, but evidence is limited to small case series and individual case reports. Br J Diabetes 2016;16:6-9

show abstract

Section: Aetiologymentioning

confidence: 99%

Section: Aetiologymentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

“…9 Squamous cell carcinomas have occasionally been reported to complicate longstanding lesions. 7,10,20,21,22 …”

Section: Clinical Featuresmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 3 more Smart Citations

Necrobiosis lipoidica

George

Walton

2015

Br J Diabetes

View full text Add to dashboard Cite

show abstract

A Solitary Red Patch

Lee

Shen

Keimig

2014

JAMA

View full text Add to dashboard Cite

Improvement in Ulcerative Necrobiosis Lipoidica After Janus Kinase–Inhibitor Therapy for Polycythemia Vera

Lee

English

2018

JAMA Dermatol

View full text Add to dashboard Cite

the potential for steroid withdrawal symptoms of burning, erythema, and edema.However, if the condition is managed with discontinuation of steroid therapy alone, the recovery period may be as long as 18 months in the genital area. 1 Recent studies have reported the successful use of β-blockers in controlling red scrotum syndrome, facial flushing, and rosacea. 3,4 It takes about 2 days for the human body system clear itself of carvedilol concentration (halflife, approximately 7-10 hours). As a result, a regimen of carvedilol, 6.25 mg, every other day was adapted to minimize risks and adverse effects (eg, orthostatic effects, hypotension, dizziness, fluid retention, bradycardia). This dosing regimen also maximizes patient confidence and compliance. The β-2 adrenergic blocking effects exerted by β-blockers and leading to vasoconstriction of cutaneous arteries may be the mechanism of action. Carvedilol has also antioxidant and anti-inflammatory effects. 5 In conclusion, carvedilol is an important therapeutic option in managing red vulva syndrome. Larger randomized trials are needed to confirm these findings.

show abstract

Update on necrobiosis lipoidica: A review of etiology, diagnosis, and treatment options

Cited by 174 publications

References 63 publications

Necrobiosis lipoidica

Necrobiosis lipoidica

A Solitary Red Patch

Improvement in Ulcerative Necrobiosis Lipoidica After Janus Kinase–Inhibitor Therapy for Polycythemia Vera

Contact Info

Product

Resources

About