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Cutis 2019 Jan;103(1):44-45

Advanced Dermatology Associates, Ltd, Allentown, Pennsylvania, USA.

Necrobiosis lipoidica (NL) is a granulomatous inflammatory skin disease strongly associated with diabetes mellitus (DM). Red-brown papules expanding into plaques with erythematous indurated borders on the lower extremities are characteristic of NL. Diagnosis is made clinically; however, biopsy of lesions confirms the diagnosis. Read More

Clin Exp Dermatol 2019 Feb 9. Epub 2019 Feb 9.

Department of Dermatology. Hospital Universitari Arnau de Vilanova, University of Lleida. IRBLleida. Lleida. Catalunya, Spain.

A 69-year-old Caucasian woman suffering from long-term diabetes mellitus type II was referred to our dermatology department with cutaneous lesions that appeared 3 years before. They were itchy and non-tender, and spreaded progressively, with no history of previous trauma. Examination revealed multiple erythematous to yellowish papules on the lower legs, which merged in plaques, of varying shapes and sizes (Fig. Read More

Dermatol Online J 2018 Dec 15;24(12). Epub 2018 Dec 15.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

We present a case of necrobiosis lipoidica (NL) of the right abdomen in a 75-year-old man. A skin biopsy performed showed a layered infiltrate of mono and multinucleated histiocytes palisaded around degenerated collagen bundles. Laboratory workup was unremarkable. Read More

Diabet Med 2019 Jan 19. Epub 2019 Jan 19.

Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, UK.

A series of clinical research projects conducted over the past 40 years, all of which were informed by clinical observation or discussions with people with diabetes and staff colleagues are described in this review. A study of necrobiosis lipoidica diabeticorum confirmed that this rare skin complication occurs predominantly in young women with Type 1 diabetes and other microvascular complications. Biopsies of necrobiotic lesions showed destruction of superficial nerve fibres by inflammatory tissue, which likely causes the sensory loss in lesions that is pathognomonic of the condition. Read More

Pediatr Dermatol 2019 Jan 2;36(1):e31-e33. Epub 2018 Dec 2.

Dermatology Department, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

Necrobiosis lipoidica (NL) is a rare chronic granulomatous inflammatory skin disease characterized by brownish-red papules and yellowish plaques with atrophic centers, which usually affect the legs, bilaterally. The average age of onset is 30-40 years, and there are very few reported cases of necrobiosis lipoidica in children. A nondiabetic girl aged 14 years presented to our clinic with a history of an asymptomatic, 7 × 5-cm single red plaque over her back in the interscapular area, which had started 5 years ago. Read More

Clin Exp Dermatol 2018 Dec 1. Epub 2018 Dec 1.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA.

Dermatol Clin 2019 Jan;37(1):49-64

Dermatology Administration, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 7th Floor, South Tower, Philadelphia, PA 19104, USA. Electronic address:

Inflammatory granulomatous dermatitides include cutaneous sarcoidosis, necrobiosis lipoidica, granuloma annulare, and reactive granulomatous dermatitis. The etiopathogenesis of these disorders is not well understood; but the T helper 1 response mediated by interferon-gamma, tumor necrosis factor-alpha, and interleukin (IL) 1, 2, and 6 and the T helper 17 response mediated by IL-17 play a role. These inflammatory granulomatous disorders often have cutaneous manifestations in addition to extracutaneous manifestations or associations with systemic diseases. Read More

Dermatology 2018 Nov 21:1-7. Epub 2018 Nov 21.

Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

Objectives: Potassium iodide (KI) is a medication that has been used for decades in dermatology and it is mentioned as a treatment option in all major dermatology textbooks. Yet, there is little recent information on its efficacy. In our study, we wanted to retrospectively evaluate the therapy response to KI in our patients. Read More

Clin Exp Dermatol 2018 Oct 2. Epub 2018 Oct 2.

Department of Dermatology, University Hospital Coventry and Warwickshire, Coventry, UK.

JAAD Case Rep 2018 Sep 14;4(8):802-804. Epub 2018 Sep 14.

Department of Dermatology, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

J Cutan Pathol 2018 Dec 9;45(12):944-948. Epub 2018 Oct 9.

Department of Dermatology, University of Virginia, Charlottesville, Virginia.

We report the case of a 40-year-old African-American female with biopsy-proven pulmonary sarcoidosis who developed atrophic plaques on her shins, trunk, and scalp that were clinically and histologically consistent with necrobiosis lipoidica (NL). The lesions appeared 3 years after her diagnosis of sarcoidosis, and progressed despite chronic prednisone. Sarcoidosis and NL are granulomatous skin disorders reported to coexist in the same patient only 10 times in the literature. Read More

Dermatol Clin 2018 Oct 2;36(4):369-375. Epub 2018 Aug 2.

Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy.

Although diagnosis of cutaneous granulomatous disorders (CGDs) is usually suspected based on morphologic findings, localization, and anamnestic data, clinical differentiation from each other and from similar dermatoses may be challenging. Recently, dermatoscopy has been demonstrated to be a useful tool for assisting the recognition of several CGDs. This article provides a current overview of the dermatoscopic features of the main noninfectious and infectious CGDs, including sarcoidosis, necrobiosis lipoidica, granuloma annulare, rheumatoid nodules, and leishmaniasis. Read More

Acta Med Port 2018 Aug 31;31(7-8):440. Epub 2018 Aug 31.

Department of Dermatology. Centro Hospitalar Lisboa Norte. Lisboa. Instituto de Medicina Molecular. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

Pan Afr Med J 2018;29:214. Epub 2018 Apr 13.

Service of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Marrakech, Marrakech, Morocco.

Acta Dermatovenerol Croat 2017 Dec;25(4):298-299

Dario Didona, MD, Prima Divisione Dermatologica , Istituto Dermopatico dell'Immacolata-IRCCS, Via dei Mont di Creta 104 , 00167 Rome, Italy;

Cutaneous sarcoidosis is not an uncommon disorder, and the skin can be the sole manifestation in about 10% of patients. However, when the involved anatomical area of the cutaneous sarcoidosis is the scalp and it presents as a scarring alopecia, there is an increased risk of a systemic disease (1,2). A 79-year-old Caucasian male patient presented to our Institute with annular and painless plaques of the scalp, with variable diameter, showing a reddish and yellowish color (Figure 1, a). Read More

J Dtsch Dermatol Ges 2018 Jul;16(7):873-890

Department of Dermatology, Venereology and Allergology, University Medical Center Bochum, Bochum, Germany.

Successful management of patients with leg ulcers requires identification of the underlying etiology, with subsequent initiation of causal treatment, if feasible. Supplementary measures of first choice include stage-adjusted wound treatment, usually combined with compression therapy. The significance of systemic drugs has been the subject of controversial debate, depending on the underlying cause of the condition. Read More

JAMA Dermatol 2018 Jun;154(6):733-734

Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Indian J Dermatol Venereol Leprol 2018 Jul-Aug;84(4):481-484

Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.

J Cosmet Laser Ther 2018 May 8:1-2. Epub 2018 May 8.

a Dermatology , Habib Thameur Hospital , Tunis , Tunisia.

Photodiagnosis Photodyn Ther 2018 Jun 4;22:223-226. Epub 2018 May 4.

Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Denmark.

Introduction: Necrobiosis lipoidica (NL) is a rare, treatment-resistant, granulomatous skin disease of unknown origin, frequently seen in patients with diabetes.

Methods: In this retrospective study we evaluated the long-term efficacy of methyl aminolaevulinate-based photodynamic therapy (MAL-PDT), including 80 treatments (70 conventional and 10 daylight PDT), on 65 unselected NL patients treated routinely in our clinic. Superficial curettage, avoiding skin oozing or bleeding, was performed prior to MAL application. Read More

Am J Dermatopathol 2018 Oct;40(10):762-766

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.

Actinic granuloma (AG) manifests as annular plaques on sun-damaged skin. There remains no universal consensus on the nosology, etiology, or clinicopathologic criteria of AG as a distinct entity. Broadly, AG is characterized by granulomatous inflammation, multinucleated giant cells, elastophagocytosis, and the absence of mucin and necrobiosis. Read More

Pan Afr Med J 2018 3;29. Epub 2018 Jan 3.

Centre Hospitalier Universitaire Hassan II, Fès, Maroc.

Necrobiosis lipoidica is a rare granulomatous dermatosis. It occurs in 0.3-1. Read More

Dermatol Online J 2017 Jul 15;23(7). Epub 2017 Jul 15.

Department of Dermatology, University of California Davis School of Medicine, Sacramento, California.

We present a 42-year-old woman with no history of diabetes or glucose intolerance who had a 5-year history of ulcerative necrobiosis lipoidica (NL). Despite failure of multiple medications, she experienced clearing of her ulcers after her treatment was changed to ustekinumab. We discuss our patient's disease course and elaborate upon mechanistic reasons for her improvement related to ustekinumab therapy. Read More

J Cosmet Laser Ther 2019 20;21(1):17-18. Epub 2018 Feb 20.

a Plastic Surgery Center of Pennsylvania , Erie , PA , USA.

A 57-year-old female was presented with an irrepressible case of Necrobiosis Lipoidica considering the possibility of a surgical skin graft. Instead, a pulsed dye laser treatment was used as an alternate treatment. Previous case studies have been found in the literature on the effect of pulsed dye laser on Necrobiosis Lipoidica. Read More

Postepy Dermatol Alergol 2017 Dec 31;34(6):618-621. Epub 2017 Dec 31.

Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.

J Dermatol 2018 Jul 6;45(7):e193-e194. Epub 2018 Feb 6.

Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Clin Rev Allergy Immunol 2018 Feb;54(1):131-146

Clinique de Dermatologie, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, CH-1211, Genève, Switzerland.

Cutaneous granulomatosis is a heterogeneous group of diseases, characterized by a skin inflammatory reaction triggered by a wide variety of stimuli, including infections, foreign bodies, malignancy, metabolites, and chemicals. From a pathogenic point of view, they are divided into non-infectious and infectious granulomas. Pathophysiological mechanisms are still poorly understood. Read More

Clin Dermatol 2018 Jan - Feb;36(1):94-100. Epub 2017 Sep 8.

Department of Dermatology, Istanbul Medeniyet University, Medical School, Istanbul, Turkey. Electronic address:

The link between the metabolic syndrome (MetS) and skin diseases is increasingly important, with new associations being discovered. The association between MetS and psoriasis or MetS and hidradenitis suppurativa is well known, although the relationship between MetS and various autoimmune or inflammatory diseases has only recently attracted interest. Some inflammatory skin diseases, such as vitiligo, scleredema, recurrent aphthous stomatitis, Behçet disease, rosacea, necrobiosis lipoidica, granuloma annulare, skin tags, knuckle pads, and eruptive xanthomas, have possible associations with MetS. Read More

An Bras Dermatol 2017 May-Jun;92(3):438-439

Department of Dermatology, Medical School, Universidade de Santo Amaro (UNISA), São Paulo, SP, Brazil.

Transl Pediatr 2017 Oct;6(4):300-312

The Ohio State University College of Medicine, Columbus, OH, USA.

The skin serves as a window for clinicians to understand, diagnose, and monitor endocrine disease. Dermatologic manifestations of endocrinopathies contribute significantly to an individual's health and quality of life. In this review, we outline various disorders of the hypothalamic-pituitary axis, thyroid gland, pancreas, adrenal gland, and androgen axis as well as hereditary endocrine syndromes. Read More

Clin Exp Dermatol 2017 Dec 20;42(8):920-921. Epub 2017 Sep 20.

Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan.

Adv Skin Wound Care 2017 Oct;30(10):469-472

Luke Ginocchio, BS, is a Medical Student; Lisa Draghi, RPA-c, is a Physician Assistant; and Farbod Darvishian, MD, is Associate Professor, NYU Langone Medical Center, New York, New York. Frank L. Ross, MD, FACS, is Associate Director, Helen L. and Martin S. Kimmel Hyperbaric and Advanced Wound Healing Center; and Associate Professor of Surgery, NYU Langone Medical Center New York, New York.

Objective: To report a case of refractory ulcerated necrobiosis lipoidica (NL) with significant response to treatment with topical tacrolimus.

Subject: A 55-year-old woman without diabetes and with a previous history of NL presented to the Helen L. and Martin S. Read More

Acta Dermatovenerol Croat 2017 Jul;25(2):167-169

Professor Joanna Maj, MD, PhD, Department and Clinic of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chałubińskiego 1, PL-50-368 Wrocław, Poland;

Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Read More

Open Access Maced J Med Sci 2017 Jul 21;5(4):543-544. Epub 2017 Jul 21.

Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Polyclinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.

We report the case of a 42 years old male patient suffering from skin changes, which appeared in the last 7-8 years. Two biopsies were performed during the evolution of the lesion. Both showed similar findings that consisted in a busy dermis with interstitial, superficial and deep infiltrates of lymphocytes and histiocytes dispersed among collagen bundles, with variable numbers of neutrophils scattered throughout. Read More

Br J Dermatol 2017 07;177(1):e2

Division of Dermatology 'U.O. Multizonale', Outpatient Consultation for Rare Diseases, 'S. Chiara' Hospital, Trento, Italy.

Eur J Intern Med 2018 04 9;50:e5-e6. Epub 2017 Jul 9.

Georgia Campus-Philadelphia College of Osteopathic Medicine (GA-PCOM) Suwanee, GA 30024, United States; Houston Medical Center, Warner Robins, GA 31088, United States. Electronic address:

Eur J Dermatol 2017 08;27(4):423-425

Department of Dermatology, Jichi Medical University, Japan.

Eur J Dermatol 2017 10;27(5):537-539

Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

Australas J Dermatol 2017 Nov 28;58(4):e268-e270. Epub 2017 Jun 28.

Pathology, Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia.

Int J Dermatol 2017 Dec 26;56(12):1319-1327. Epub 2017 Jun 26.

Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada.

The association of specific skin disorders with diabetes mellitus (DM) has been well established. Current literature suggests that approximately 30-91% of patients with diabetes will experience at least one cutaneous manifestation of this systemic disease in their lifetime. To date, there are limited articles summarizing the link between necrobiosis lipoidica diabeticorum (NLD) prognosis and glycemic control in patients with diabetes. Read More

Hautarzt 2017 Aug;68(8):614-620

Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.

Chronic wounds often manifest as ulcers on the lower legs. The main causes of chronic leg ulcers are chronic venous insufficiency and/or peripheral arterial occlusive disease in approximately 80% of all patients. However, there are also numerous other potentially relevant factors which can cause or almost impede the healing of chronic leg ulcers. Read More

Hautarzt 2017 Aug;68(8):625-631

Klinik- und Poliklinik für Haut- und Geschlechtskrankheiten, Universitätsmedizin Greifswald, F.-Sauerbruchstr., 17475, Greifswald, Deutschland.

Background: Medical compression therapy is widely used to treat phlebologic diseases. Compression bandages as well as compression stockings are used. Compression has been identified to be an effective conservative therapy for the healing of venous ulcers and other indications. Read More

Hautarzt 2017 Jul;68(7):536-541

Hautklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.

The palisading granulomatous dermatitides comprise a group of different skin diseases with similar histomorphologic forms of granuloma in the skin. Histopathologically characteristic are areas in the reticular dermis and subcutaneous fat with degenerated bundles of collagen surrounded by histiocytes and multinucleate giant cells aligned in a palisade (necrobiotic granuloma). Within the center of palisaded granulomas, mucin or fibrin can be found. Read More

Skin Appendage Disord 2017 May 16;3(2):92-94. Epub 2017 Mar 16.

Department of Dermatology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

Am J Clin Dermatol 2017 Aug;18(4):541-553

Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.

Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Read More

JAAD Case Rep 2017 Mar 12;3(2):127-130. Epub 2017 Mar 12.

Department of Dermatology, Saint Louis University, Saint Louis, Missouri.

Hautarzt 2017 Jun;68(6):483-491

Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.

Background: More than 1 million people in Germany suffer from leg ulcers. The diagnosis leg ulcer summarizes many different etiologies. The therapy of leg ulcers is an interdisciplinary and interprofessional challenge. Read More

J Dermatol 2017 Mar;44(3):297-303

Department of Dermatology, Kyoto prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

A granuloma is a form of inflammation, which predominantly consists of macrophages. It typically develops when the immune system attempts to enclose substances that are usually insoluble and cannot be eliminated to prevent the spread of these substances to the other body compartments. According to the source of the substances, granulomatous diseases can be divided into two groups: infectious and non-infectious. Read More

An Bras Dermatol 2017 Jan-Feb;92(1):8-20

Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) -Botucatu (SP), Brazil.

Several dermatoses are routinely associated with diabetes mellitus, especially in patients with chronic disease. This relationship can be easily proven in some skin disorders, but it is not so clear in others. Dermatoses such necrobiosis lipoidica, granuloma annulare, acanthosis nigricans and others are discussed in this text, with an emphasis on proven link with the diabetes or not, disease identification and treatment strategy used to control those dermatoses and diabetes. Read More