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Pediatr Dermatol 2020 Jul 18. Epub 2020 Jul 18.

Department of Dermatology, Baylor College of Medicine, Houston, TX, USA.

Necrobiosis lipoidica (NL) is a rare granulomatous disease of unknown etiology. Multiple therapies may be used with varying efficacy. We report a pediatric patient with a history of type I diabetes mellitus and NL with minimal response to an ultrapotent topical steroid, topical calcineurin inhibitor, and intralesional triamcinolone, complicated by steroid atrophy, who rapidly responded after addition of doxycycline. Read More

Oman Med J 2020 May 30;35(3):e135. Epub 2020 Jun 30.

Department of Internal Medicine, Endocrine Division, King Hussein Medical Centre, Amman, Jordan.

Congenital generalized lipodystrophy (Berardinelli-Seip syndrome) is an autosomal recessive condition, presenting during infancy with generalized loss of fat. We report a 30-year-old female patient with diabetes who has acromegaloid features, prominent umbilicus, prominent muscles, prominent subcutaneous veins, and gross hepatomegaly. Near-total loss of subcutaneous fat was confirmed by whole-body magnetic resonance imaging and laboratory data revealed significant hypertriglyceridemia, uncontrolled diabetes mellitus, and heavy proteinuria with stage IIIa chronic kidney disease. Read More

Int J Dermatol 2020 Jul 2. Epub 2020 Jul 2.

Department of Dermatology, Fukushima Medical University, Fukushima, Japan.

Hemoglobin 2020 May 1;44(3):221-223. Epub 2020 Jul 1.

Adult Thalassemia Unit, Second Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Necrobiosis lipoidica (NL) is a rare granulomatous disease that predominantly affects middle-aged women and is often associated with diabetes mellitus (DM), rheumatoid arthritis (RA) and other metabolic disorders. Thalassemias are the most common hereditary hemoglobin (Hb) disorders worldwide. A few studies investigated dermatologic problems that coexist with β-thalassemia major (β-TM). Read More

Actas Dermosifiliogr 2020 Jun 20. Epub 2020 Jun 20.

Servicio de Dermatología, Instituto Valenciano de Oncología (IVO), Valencia, España.

Necrobiosis lipoidica is a rare chronic granulomatous disease. Multiple treatment approaches are available, but results are generally minimal and inconsistent. Some publications report variable results with photodynamic therapy (PDT) as a second line of treatment for refractory cases. Read More

Clin Case Rep 2020 May 27;8(5):808-810. Epub 2020 Mar 27.

Institute of Dermatology Catholic University of Rome Rome Italy.

Perforating necrobiosis lipoidica (PNL) is a granulomatous inflammatory skin disease that usually occurs in patients with diabetic. We present a case of a female patient affected by a disseminated form of necrobiosis lipoidica. Read More

Semergen 2020 May 19. Epub 2020 May 19.

Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.

Dermatol Ther 2020 May 1:e13484. Epub 2020 May 1.

Dermatology Department, Hospital Universitario San Cecilio, Granada, Spain.

Yale J Biol Med 2020 03 27;93(1):187-195. Epub 2020 Mar 27.

Department of Dermatology, Yale School of Medicine, New Haven, CT.

Certain inflammatory disorders are characterized by macrophage activation and accumulation in tissue; sometimes leading to the formation of granulomas, as in sarcoidosis. These disorders are often difficult to treat and more effective, molecularly targeted therapies are needed. Recent work has shown that overproduction of inflammatory cytokines, such as interferon gamma (IFN-γ) leading to constitutive activation of the JAK-STAT pathway may be a conserved feature of these disorders. Read More

J Eur Acad Dermatol Venereol 2020 Jul 15;34(7):e331-e333. Epub 2020 Mar 15.

Department of Dermatology, University Hospital Erlangen, Erlangen, Germany.

Indian Dermatol Online J 2020 Jan-Feb;11(1):83-86. Epub 2019 Sep 26.

Department of Dermatology and Venereology, Centro Hospitalar e Universitário de São João EPE, Porto, Portugal.

Necrobiotic xanthogranuloma (NXG) is a rare form of inflammatory granulomatous disease of the skin characterized by the presence of pruritic to painful lesions, generally located in the periorbital area, although trunk and proximal extremities may also be involved. We report a case of a 69-year-old male patient with extensive involvement of the trunk, upper and lower extremities, and an associated gamma monoclonal gammopathy. The skin biopsy was consistent with the diagnosis of NXG. Read More

J Drugs Dermatol 2020 Jan;19(1):92-94

BACKGROUND: Necrobiosis lipoidica (NL) and sarcoidosis are granulomatous disorders with an unknown pathogenesis. They may coexist in the same patient, which suggests a possible overlap between these diseases among shared granulomatous inflammatory pathways. Case Presentation: This study presents the case of a non-diabetic 52-year-old woman who presented with red-yellowish border plaques on the face and upper extremities previously diagnosed as sarcoidosis. Read More

JAAD Case Rep 2020 Feb 24;6(2):133-135. Epub 2020 Jan 24.

Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.

Diabetes Metab 2020 Jan 22. Epub 2020 Jan 22.

Hôpital Haut-Levêque, USN, avenue Magellan, 33604 Pessac/Bordeaux, Aquitaine, France.

CMAJ 2020 01;192(2):E41

Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy Medical Science & Peking Union Medical College, Beijing, China

Beijing Da Xue Xue Bao Yi Xue Ban 2019 Dec;51(6):1182-1184

Department of Rheumatology and Immunology, Shanxi Bethune Hospital, Taiyuan 030032, China.

A 61-year-old woman was referred to our department with a 11-year-erythra. In the anterior tibia of both lower extremities, we could see large dark red infiltrating erythema, waxy luster, clear boundary, slight central atrophy, depression and capillary dilatation. He was diagnosed with "dermatitis contusiformis" in local hospitals, but the treatment of traditional Chinese medicine and external drugs was not effective. Read More

An Bras Dermatol 2019 Nov - Dec;94(6):769-771. Epub 2019 Nov 4.

Dermatological Medical Residency Program in Dermatology of the Hospital Universitário Polyodoro Ernani de São Thiago, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.

Niger J Clin Pract 2019 Nov;22(11):1626-1628

Dermatology Unit, Department of Medicine, Kaduna State University/Barau Dikko Teaching Hospital, Kaduna, Nigeria.

Necrobiosis lipoidica (NL), one of a group of "necrobiotic" granulomatous cutaneous disorders, is characterized histologically by layers of poorly defined, horizontally oriented, altered "necrobiotic" collagen surrounded by, and alternating with, layers of chronic inflammatory cells, histiocytes, and giant cells throughout the full thickness of the dermis. It is a rare disease associated mostly with diabetes mellitus in whom it may affect 0.3%-1. Read More

SAGE Open Med Case Rep 2019 18;7:2050313X19881594. Epub 2019 Oct 18.

Department of Dermatology, University of Toronto, Toronto, ON, Canada.

Necrobiosis lipoidica is a chronic granulomatous disease historically associated with diabetes. Necrobiosis lipoidica commonly presents with erythematous papules or plaques on the anterior lower extremities, which can be ulcerated in up to 30% of patients. The pathophysiology of necrobiosis lipoidica is unknown but proposed to be predominantly linked to microangiopathy. Read More

Dermatol Online J 2019 Aug 15;25(8). Epub 2019 Aug 15.

Department of Dermatology, University of California, Davis, Sacramento, CA Department of Biological Sciences, Davis, CA California State University, Sacramento, CA.

Necrobiosis lipoidica is a chronic granulomatous disease of unknown etiopathogenesis, which is often difficult to treat. While data from randomized controlled trials for the treatment of necrobiosis lipoidica is lacking, several treatments of varying efficacy for necrobiosis lipoidica have been reported in the scientific literature. We present a case of a 29-year-old female with uncontrolled diabetes and treatment-resistant necrobiosis lipoidica which was responsive to ustekinumab. Read More

Am J Med 2020 03 12;133(3):e112. Epub 2019 Sep 12.

Department of Endocrinology and Diabetes, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France.

JAAD Case Rep 2019 Sep 29;5(9):749-751. Epub 2019 Aug 29.

Department of Dermatology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.

Dermatol Surg 2019 Aug 21. Epub 2019 Aug 21.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York Laser and Skin Surgery Center of New York, New York, New York.

Int Wound J 2019 Oct 14;16(5):1234-1236. Epub 2019 Aug 14.

Department of Dermatology, Hospital Universitario Infanta Leonor y Virgen de la Torre, Madrid, Spain.

Ned Tijdschr Geneeskd 2019 08 6;163. Epub 2019 Aug 6.

Amsterdam UMC, locatie Louwesweg, polikliniek Vrouw en Kind, Amsterdam.

Background: Necrobiosis lipoidica is a painless but disfiguring skin condition regularly complicated by ulceration and that is related to diabetes mellitus.

Case Description: We present the case of a 17-year-old girl with type 1 diabetes mellitus in whom necrobiosis lipoidica was diagnosed. After falling with a bicycle, a traumatic ulcer developed. Read More

Am J Dermatopathol 2020 Apr;42(4):308-311

Departments of Pathology, University of Illinois College of Medicine, Chicago, IL.

Acta Med Port 2019 Jun;32(6):459-465

Clínica Universitária de Dermatologia. Hospital de Santa Maria. Lisbon. Portugal.

Diabetes is a serious, chronic disease with a rising prevalence worldwide. Its complications are a major cause of morbidity and mortality and contribute substantially to health care costs. In this article the authors review the most common and sensitive skin manifestations that can be present on patients with diabetes and prediabetes. Read More

Australas J Dermatol 2019 Nov 3;60(4):e346-e348. Epub 2019 Jun 3.

Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA.

Am J Dermatopathol 2020 Apr;42(4):307-308

Meguro Chen Dermatology Clinic, Tokyo, Japan.

J Dtsch Dermatol Ges 2019 May;17(5):518-533

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

Granulomatous dermatoses comprise a wide range of etiologically and clinically distinct skin diseases that share a common histology characterized by the accumulation of histiocytes include macrophages. While the pathogenesis of these disorders is not fully understood, the underlying mechanism is thought to involve a reaction pattern caused by an immunogenic stimulus. Antigen-presenting cells and the effect of various cytokines play a key role. Read More

Ann Nutr Metab 2019 16;74(4):339-347. Epub 2019 May 16.

Department of Pediatrics, Novosibirsk Medical University, Novosibirsk, Russian Federation.

Background: Youth-onset type 2 diabetes (T2D) is increasing in many countries, creating large personal and societal burdens. While many primary health-care professionals (HCPs) are aware of the classic symptoms of T2D, there are several other manifestations that could indicate its presence.

Summary: This narrative review summarizes information on these symptoms and indicators, focusing on those less well known. Read More

J Surg Case Rep 2019 Mar 29;2019(3):rjz088. Epub 2019 Mar 29.

Department of Abdominal Surgery, University Clinical Center of Kosovo, Str. 'Bulevardi i Deshmoreve', Prishtina, Republic of Kosovo.

Necrobiosis lipoidica is an idiopathic dermatosis of unknown origin, occurring mainly in patients with diabetes. Splenic abscesses are rare entities. We report a case with concomitant necrobiosis lipoidica and splenic abscess. Read More

JAAD Case Rep 2019 Mar 2;5(3):255-257. Epub 2019 Mar 2.

Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania.

Rheumatology (Oxford) 2019 09;58(9):1702-1703

Department of Dermatology.

Endocrinol Diabetes Metab Case Rep 2019 Mar 14;2019. Epub 2019 Mar 14.

Wolfson Diabetes Centre, Addenbrooke's Hospital Cambridge, Cambridge, UK.

Necrobiosis lipoidica diabeticorum (NLD) is a chronic granulomatous dermatitis generally involving the anterior aspect of the shin, that arises in 0.3-1.2% of patients with diabetes mellitus (1). Read More

JAMA Dermatol 2019 04;155(4):455-459

Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

Importance: Necrobiosis lipoidica (NL) is a rare granulomatous condition. Current knowledge of its key features is based on a limited number of studies and case reports, leading to wide variability in the characterization of its defining features, with limited comparison of patients with or without diabetes.

Objective: To evaluate the epidemiologic characteristics, clinical features, and disease associations of NL in patients with or without type 1 or 2 diabetes. Read More

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 06 27;44(4):e159-e160. Epub 2019 Feb 27.

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

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 12 14;36(12):1539-1549. Epub 2019 Feb 14.

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

J Dermatolog Treat 2020 Feb 17;31(1):74-76. Epub 2019 Oct 17.

Department of Dermatology, School of Medicine, University of California, Davis, CA, USA.

Ultrasound is currently underutilized in dermatology practice. However, ultrasound provides clinicians with precise and unique information on cutaneous and subcutaneous lesions, while minimizing costs and complications related to more common and invasive diagnostic methods. We report a patient who presented with a tender subcutaneous mass that was diagnosed and treated using point-of-care ultrasound-guidance at the dermatology clinic. 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 2019 Aug 1;44(6):674-676. 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 2019 21;235(2):137-143. 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 2019 Jun 2;44(4):441-443. 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.