LAB TEST
Necrobiosis lipoidica diabeticorum
Necrobiosis lipoidica diabeticorum is an uncommon skin condition related to diabetes . It results in reddish brown areas of the skin, most commonly on the lower legs.
Causes
The cause of necrobiosis lipoidica diabeticorum (NLD) is unknown. It is thought to be linked to blood vessel inflammation related to autoimmune factors . This damages proteins in the skin (collagen). People with type 1 diabetes are more likely to get NLD than those with type 2 diabetes. Women are more affected than…
Symptoms
A skin lesion is an area of skin that is different from the skin around it. With NLD, skin lesions start as firm, smooth, red bumps (papules) on the shins and lower part of the legs. They usually appear in the same areas on opposite sides of the body. They are painless in the early stage. As the papules become bigger,…
Exams and Tests
Your health care provider can examine your skin to confirm the diagnosis. If needed, your provider may do a punch biopsy to diagnose the disease. The biopsy removes a sample of tissue from the edge of the lesion. Your provider may do a glucose tolerance test to see if you have diabetes.
Treatment
NLD can be difficult to treat. Control of blood glucose does not improve symptoms. Treatment may include: Corticosteroid creams Injected corticosteroids Medicines that suppress the immune system Anti-inflammatory medicines Medicines that improve blood flow Hyperbaric oxygen therapy may be used to increase the amount…
Outlook (Prognosis)
NLD is a long-term disease. Lesions do not heal well and can recur. Ulcers are difficult to treat. The appearance of the skin may take a long time to become normal, even after treatment.
Possible Complications
NLD can rarely result in skin cancer ( squamous cell carcinoma ). Those with NLD are at increased risk for: Diabetic retinopathy Diabetic nephropathy
When to Contact a Medical Professional
Contact your provider if you have diabetes and notice non-healing lesions on your body, especially on the lower part of legs.
References
Fitzpatrick JE, High WA, Kyle WL. Annular and targetoid lesions. In: Fitzpatrick JE, High WA, Kyle WL, eds. Urgent Care Dermatology: Symptom-Based Diagnosis . Philadelphia, PA: Elsevier; 2018:chap 16. James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Errors in metabolism. In: James WD, Elston DM, Treat JR,…
This is a summary. Read the full article at www.ucsfbenioffchildrens.org (reviewed 21/07/2024).
This page is general information and is not medical advice. It does not replace a registered doctor, and it is not a prescription or a recommendation to use any medicine or test. Prices are listed prices and may change. Always follow the advice of your doctor or pharmacist.