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    1 OF 18

    Cutaneous Manifestations of Diabetes Mellitus: A Review.
    Am J Clin Dermatol 2017 Apr 3. Epub 2017 Apr 3.
    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

    [First manifestation of leg ulcers : Analysis of data from 1000 patients].
    Hautarzt 2017 Mar 9. Epub 2017 Mar 9.
    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

    What is new in the histogenesis of granulomatous skin diseases?
    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

    Diabetes mellitus and the skin.
    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

    Update: Treatment of necrobiosis lipoidica.
    J Dtsch Dermatol Ges 2017 Feb;15(2):151-157
    Department of Dermatology, University Hospital, Jena, Germany.
    Necrobiosis lipoidica (NL) is a rare granulomatous disease of hitherto unclear etiology frequently seen in patients with diabetes. Characterized by its potential for ulcerations, it often presents a serious burden for those affected. There are currently neither German nor European guidelines for the treatment of NL. Read More

    Update: Therapie der Necrobiosis lipoidica.
    J Dtsch Dermatol Ges 2017 Feb;15(2):151-158
    Klinik für Hautkrankheiten, Universitätsklinikum Jena.
    Die Necrobiosis lipoidica ist eine seltene granulomatöse Erkrankung von bisher unzureichend geklärter Ätiologie. Häufig stellt die bei Diabetikern gehäuft zu beobachtende und zur Ulzeration neigende Dermatose eine starke Belastung für die Patienten dar. Bezüglich der Therapie existieren aktuell keine deutschen oder europäischen Leitlinien. Read More

    A granulomatous conundrum: Concurrent necrobiosis lipoidica, cutaneous sarcoidosis and erythema nodosum in a nondiabetic patient.
    Australas J Dermatol 2017 Feb 17. Epub 2017 Feb 17.
    Australian National University Medical School, Canberra, Australian Capital Territory, Australia.
    Necrobiosis lipoidica (NL) and cutaneous sarcoidosis are granulomatous disorders with a largely unknown aetiopathogenesis. Evidence of co-existing NL and sarcoidosis in the same patient may suggest a degree of overlap between these entities through shared granulomatous inflammatory pathways. Occasionally, one condition can mimic the other, making their distinction difficult. Read More

    Panniculitis: A summary.
    Semin Diagn Pathol 2016 Dec 27. Epub 2016 Dec 27.
    Section of Dermatopathology,Dermatopathology, Division of Surgical Pathology & Cytopathology, University of Virginia Medical Center, Charlottesville, VA, USA. Electronic address:
    The diagnosis of panniculitis is felt to be a confusing topic by some pathologists. This summarical article presents inflammatory diseases of the subcutis in a systematic fashion, based on whether they are centered on fibrovascular septa or the adipose lobules, and whether morphologic vasculitis is present or not. Septocentric, non-vasculitis disorders include erythema nodosum, panniculitis that follows the use of "biological" therapeutic agents, lipodermatosclerosis, post-irradiation panniculitis, morphea profunda, and necrobiosis lipodica profunda. Read More

    Granulomatous & histiocytic dermatitides.
    Semin Diagn Pathol 2016 Dec 14. Epub 2016 Dec 14.
    Section of Dermatopathology, Division of Surgical & Cytological Pathology, University of Virginia Medical Center, Charlottesville, VA, USA. Electronic address:
    Granulomas of the skin may be classified in several ways. They are either infectious or non-infectious in character, and they contain areas of necrobiosis or necrosis, or not. Responsible infectious agents may be mycobacterial, fungal, treponemal, or parasitic organisms, and each case of granulomatous dermatitis should be assessed histochemically for those microbes. Read More


    Specific skin signs as a cutaneous marker of diabetes mellitus and the prediabetic state - a systematic review.
    Dan Med J 2017 Jan;64(1)
    Introduction: Diabetes mellitus and the prediabetic state are associated with a number of skin manifestations. This study is a systematic review of the following manifestations: acanthosis nigricans (AN), skin tags (ST), diabetic dermopathy (DD), rubeosis faciei (RF), pruritus (PR), granuloma annulare (GA), necrobiosis lipoidica (NL), scleroedema diabeticorum (SD) and bullosis diabeticorum (BD). These conditions possibly relate to underlying diabetogenic mechanisms. Read More

    Subcutaneous dirofilariasis: a masquerade of a palisaded granulomatous dermatitis.
    J Cutan Pathol 2017 Apr 15;44(4):373-375. Epub 2017 Feb 15.
    Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
    Dirofilaria species are roundworms responsible for "heartworm" in canines. On occasion, humans are an accidental host, resulting in pulmonary (Dirofilaria immitis) or extrapulmonary (Dirofilaria repens) manifestations. Of the extrapulmonary sites of involvement, subcutaneous involvement is particularly common. Read More

    Dermoscopy could be useful in differentiating sarcoidosis from necrobiotic granulomas even after treatment with systemic steroids.
    Dermatol Pract Concept 2016 Jul 31;6(3):17-22. Epub 2016 Jul 31.
    Dermatology Department Cairo University, Cairo, Egypt.
    Background: Diagnosing cutaneous sarcoidosis and necrobiotic granulomas is challenging.

    Objective: Assessing the value of dermoscopy in differentiating cutaneous sarcoidosis from necrobiotic granulomas and evaluating whether their dermoscopic features will be altered after treatment.

    Methods: Nineteen cutaneous sarcoidosis and 11 necrobiotic granuloma patients (2 necrobiosis lipoidica, 4 granuloma annulare and 5 rheumatoid nodule) were included in this study. Read More

    An atrophic plaque on the breast six years after breast reconstruction surgery.
    Dermatol Online J 2016 Jun 15;22(6). Epub 2016 Jun 15.
    Department of Dermatology, Sidney Kimmel Medical College at Thomas Jefferson University.
    Necrobiosis lipoidica (NL) is a cutaneous disease entity that typically manifests as atrophic yellow plaques with telangiectasias on the anterior tibial region. Although NL is commonly associated with diabetes mellitus, the role of trauma in disease development is less commonly emphasized. The relationship between NL and the Köbner phenomenon has been established, as a few cases of NL occurring in surgical scars have been reported in the literature. Read More

    Dermoscopy in General Dermatology: A Practical Overview.
    Dermatol Ther (Heidelb) 2016 Dec 9;6(4):471-507. Epub 2016 Sep 9.
    Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.
    Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. Read More

    Ultraviolet A1 phototherapy: One center's experience.
    Indian J Dermatol Venereol Leprol 2017 Jan-Feb;83(1):60-65
    Department of Dermatology and Photobiology, Ninewells University Hospital, Dundee, DD1 9SY, Scotland, UK.
    Background: Ultraviolet A1(UVA1) phototherapy is increasingly being used in the treatment of morphea, atopic dermatitis, lupus and some other recalcitrant dermatoses. We present a retrospective review of our experience with this modality.

    Aim: To evaluate the treatment response rates for various dermatoses and adverse effects of UVA1 phototherapy. Read More

    Risk factors for necrobiosis lipoidica in Type 1 diabetes mellitus.
    Diabet Med 2017 Jan 21;34(1):86-92. Epub 2016 May 21.
    Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
    Aims: To compare the clinical and metabolic characteristics of patients with Type 1 diabetes and necrobiosis lipoidica with those of patients with Type 1 diabetes who do not have necrobiosis lipoidica. A multicentre analysis was performed.

    Methods: Clinical and laboratory data were obtained from 64 133 patients (aged 0-25 years) with Type 1 diabetes with and without necrobiosis lipoidica who were registered in the German/Austrian Diabetes Prospective Documentation Initiative registry. Read More

    Dermatological and musculoskeletal assessment of diabetic foot: A narrative review.
    Diabetes Metab Syndr 2016 Apr-Jun;10(2 Suppl 1):S158-64. Epub 2016 Mar 12.
    Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Electronic address:
    Aims: Diabetic Foot Syndrome (DFS) is the most costly and devastating complication of diabetes mellitus (DM), which early effective assessment can reduce the severity of complications including ulceration and amputations. This study aimed to review dermatological and musculoskeletal assessment of diabetic foot.

    Materials And Methods: In this review article, we searched for articles published between March 1, 1980 and July 28, 2015 in PubMed, Science Direct, Embase, Web of Science, and Scopus, for both English and non-English language articles with the following keywords: "Diabetic foot syndrome", "Ulceration", "Amputation", "Foot assessment", "Skin disorders" and "Musculoskeletal deformities". Read More

    Sarcoidal Necrobiosis Lipoidica in a Nondiabetic Patient: Usefulness of Skin Ultrasound.
    Actas Dermosifiliogr 2016 Jul-Aug;107(6):525-7. Epub 2016 Mar 19.
    Departamentos de Radiología y Dermatología, Instituto de Investigación y Diagnóstico por Imágenes en Piel y Tejidos Blandos (IDIEP), Clínica Servet, Facultad de Medicina, Universidad de Chile, Santiago, Región Metropolitana, Chile.

    Anti-TNFα treatment for recalcitrant ulcerative necrobiosis lipoidica diabeticorum: A case report and review of the literature.
    Metabolism 2016 Apr 7;65(4):569-73. Epub 2016 Jan 7.
    First Department of Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, 17 Agiou Thoma St, Goudi, Athens, Greece. Electronic address:
    Introduction: Necrobiosis lipoidica diabeticorum (NLD) is a rare degenerative connective tissue disorder associated with diabetes mellitus, which usually presents with red papules or plaques with raised edges and occasional ulceration. Ulcerating NLD is notoriously difficult to treat. We present a young patient with ulcerative NLD who was successfully treated with the anti-TNFα agent infliximab. Read More

    Cofactors and comorbidities of necrobiosis lipoidica: analysis of the German DRG data from 2012.
    J Dtsch Dermatol Ges 2016 Mar;14(3):277-84
    Department of Dermatology, Venereology, and Allergology, University Hospital Essen, Essen, Germany.
    Background: Necrobiosis lipoidica (NL) is a rare granulomatous inflammatory skin disease of unknown pathophysiology. Its potential association with diabetes mellitus is well known. Other relevant cofactors and comorbidities are subject to controversial debate. Read More

    Treatment of refractory ulcerative necrobiosis lipoidica diabeticorum with oral thalidomide.
    Indian Dermatol Online J 2016 Jan-Feb;7(1):43-5
    Department of Dermatology and Venereology, Ashvini Rural Medical College, Solapur, Maharashtra, India.
    Ulcerative necrobiosis lipoidica (NL) in diabetic patients is a rare, painful condition. It is a difficult-to-treat condition, impairing quality of life of patients. Although various drugs have been tried, none of them is consistently effective. Read More

    Scald-Induced Necrobiosis Lipoidica in a Patient with Diabetes Mellitus and Psoriasis.
    Case Rep Dermatol 2016 Jan-Apr;8(1):1-4. Epub 2016 Jan 8.
    Department of Dermatology, Jyujyo Takeda Rehabilitation Hospital, Kyoto, Japan.
    The Koebner phenomenon (KP) was first introduced by Heinrich Koebner in the 1870s to describe the appearance of psoriatic lesions following trauma in psoriasis patients. KP has since been defined in numerous diseases, including necrobiosis lipoidica diabeticorum (NLD). Since most Koebnerized dermatological lesions can localise to a site of previous trauma, Weiss et al. Read More

    [Non-infectious granulomatous inflammation: Focus on the lungs and skin].
    Pathologe 2016 Mar;37(2):172-82
    Dermatopathologie Lübeck, Lübeck, Deutschland.
    Whereas a granulomatous reaction represents a physiologically useful immune defense mechanism against many infections, in autoimmune diseases granuloma formation and the concomitant inflammatory mechanisms may provoke a potentially organ-threatening reaction. Morphologically, several defined sub-types of granuloma have long been known, e.g. Read More

    Lymphocytic panniculitis: an algorithmic approach to lymphocytes in subcutaneous tissue.
    J Clin Pathol 2015 Dec;68(12):954-62
    Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada Department of Pathology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
    The diagnosis of panniculitis is a relatively rare occurrence for many practising pathologists. The smaller subset of lymphocyte-predominant panniculitis is further complicated by the diagnostic consideration of T cell lymphoma involving the subcutaneous tissue, mimicking inflammatory causes of panniculitis. Accurate classification of the panniculitis is crucial to direct clinical management as treatment options may vary from non-medical therapy to immunosuppressive agents to aggressive chemotherapy. Read More

    Updated results of 100 patients on clinical features and therapeutic options in necrobiosis lipoidica in a retrospective multicentre study.
    Eur J Dermatol 2015 Nov-Dec;25(6):595-601
    Department of Dermatology, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
    Background: Necrobiosis lipoidica (NL) is a rare granulomatous disorder of unknown aetiology which can manifest in ulcerative skin lesions and is widely recognised in association with diabetes. We evaluated in total 100 patients to improve knowledge about the epidemiology and clinical course of NL. Additionally we focused on treatment options according to evidence level and expert opinion. Read More

    Pentoxifylline: An effective therapy for necrobiosis lipoidica.
    Australas J Dermatol 2017 Feb 12;58(1):65-68. Epub 2015 Nov 12.
    Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
    Necrobiosis lipoidica (NL) is a rare chronic inflammatory granulomatous skin disorder that remains challenging to treat. Here we report three patients at different stages of disease successfully treated with pentoxifylline, a haemorrheological and anti-inflammatory agent. We demonstrate for the first time that early stage NL may be completely reversible with this treatment. Read More

    [Squamous cell carcinoma developing in necrobiosis lipoidica in a diabetic patient].
    Ugeskr Laeger 2015 Sep;177(38):V01150054
    The development of squamous cell carcinoma in chronic and/or non-healing ulcers associated with necrobiosis lipoidica (NL) is rare, but should be considered in diabetic patients. NL is a non-infectious granulomatous degenerative skin disease. The prevalence of NL in diabetic patients is estimated to 0,3-1,2%. Read More

    Dermatopathologic manifestations of intravenous drug use.
    J Cutan Pathol 2015 Nov 9;42(11):815-23. Epub 2015 Oct 9.
    Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
    Background: The rate of intravenous drug use (IVDU) has been increasing nationally; however, cutaneous manifestations of IVDU have infrequently been investigated. We report a series of the clinicopathological correlation of IVDU in the skin.

    Methods: A search of surgical pathology files between the years 2000 and 2014 was performed for cutaneous specimens from patients with a reported history of IVDU for which the histopathological findings could not be attributed to another etiology. Read More

    O'Brien Actinic Granuloma: A Case Report and Brief Review of Literature.
    Indian J Dermatol 2015 Jul-Aug;60(4):391-3
    Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal.
    O'Brien first described the actinic granuloma in 1975, as an infrequent granulomatous disorder occurring in sun-exposed skin, with a slow but often self-limited course. Ever since its initial description, the actinic physiopathogenic hypothesis has been debated by many authors. We report a 60-year-old female rural worker that presented with a 14 × 7 cm annular lesion with erythematous elevated borders and an atrophic center on the right calf. Read More

    Necrobiosis lipoidica associated with Hashimoto's thyroiditis and positive detection of ANA and ASMA autoantibodies.
    Clin Case Rep 2015 Jul 13;3(7):539-41. Epub 2015 May 13.
    Department of Clinical and Experimental Medicine, University of Messina, University Hospital "G. Martino" Messina, Italy.
    Necrobiosis lipoidica (NL) is a rare idiopathic cutaneous condition exceptionally associated with autoimmune thyroiditis. We describe the first case of NL, Hashimoto's thyroiditis and positive detection of autoantibodies. Appropriate screening for NL in patients with autoimmune thyroiditis may clarify its real incidence and the existence of a common pathogenetic pathway. Read More

    [Selected skin involvement of necrobiosis lipoidica type and skin and mucous membrane fungal infections in diabetes mellitus].
    Vnitr Lek 2015 Jun;61(6):592-6
    Article reviews some skin and mucosal lesions associated with diabetes mellitus with focus on skin fungal infections and necrobiosis lipoidica.Key words: diabetes mellitus - necrobiosis lipoidica - skin and mucous membrane fungal infections in diabetes mellitus - skin involvement. Read More

    Treatment Modalities of Necrobiosis Lipoidica: A Concise Systematic Review.
    Dermatol Reports 2015 May 8;7(2):5749. Epub 2015 Jun 8.
    Department of Dermatology, Jahrom University of Medical Sciences , Iran.
    Necrobiosis lipoidica (NL) is a rare inflammatory granulomatous skin disorder closely associated with diabetes mellitus. The aim of this paper is to review and discuss all the treatment modalities proposed and tested for this disease. A systematic review of the existing literature was conducted to investigate all the available data and summarize all the clinical trials, case reports and original articles on NL. Read More

    Fifty shades of yellow: a review of the xanthodermatoses.
    Int J Dermatol 2015 Oct 30;54(10):1109-23. Epub 2015 Jul 30.
    University of New South Wales, Sydney, New South Wales, Australia.
    The xanthodermatoses consist of a heterogeneous group of cutaneous disorders characterized by the macroscopic yellow hue seen on examination. This hue is attributable to the chemical structure of the accumulating substances within the skin or surrounding tissues. The most common culprits are lipids (cholesterol and triglycerides), elastin, and bilirubin. Read More

    Necrobiosis Lipoidica.
    Dermatol Clin 2015 Jul;33(3):343-60
    Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada. Electronic address:
    Necrobiosis lipoidica is a granulomatous condition presenting as indolent atrophic plaques, often on the lower extremities. There is a multitude of case reports suggesting possible associations and documenting different therapeutic alternatives with varied success. Important complications include ulceration and the development of squamous cell carcinoma. Read More

    Necrobiosis lipoidica: a descriptive study of 35 cases.
    Actas Dermosifiliogr 2015 Jun 26;106(5):402-7. Epub 2015 Feb 26.
    Servicio de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, España.
    Introduction And Objectives: Necrobiosis lipoidica (NL) is a chronic idiopathic granulomatous disease considered to occur in association with diabetes mellitus. Data on the frequency of this association, however, are inconsistent. Our aim was to retrospectively analyze the clinical characteristics of patients diagnosed with NL at our hospital and to investigate the association with diabetes mellitus and other diseases. Read More

    Granuloma annulare and necrobiosis lipoidica with sequential occurrence in a patient: report and review of literature.
    Dermatol Pract Concept 2015 Jan 30;5(1):29-34. Epub 2015 Jan 30.
    Audubon Dermatology, New Orleans, Louisiana, USA.
    Granuloma annulare (GA) and necrobiosis lipoidica (NL) are granulomatous diseases of undetermined etiology. Rarely, both dermatoses have been reported to occur concomitantly in patients. GA and NL are characterized histologically by areas of necrobiosis of collagen. Read More

    Specific features of a rare form of disseminated necrobiosis lipoidica granuloma annulare type: a case report.
    Rom J Morphol Embryol 2014 ;55(4):1455-61
    Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania;
    Necrobiosis lipoidica (NL) is a rare dermatosis that has been shown to precede the onset of diabetes mellitus in 15% of patients. It is more common in women; the average age of the onset is 30 years. Skin lesions of classic NL begin as a small papule, typically on the bilateral pretibial area. Read More

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