Necrobiosis lipoidica

Necrobiosis lipoidica, with the added word "diabeticorum" when the patient has diabetes, is a granulomatous condition of the skin, histologically related to granuloma annulare. Indeed, many lesions are indistinguishable from those of granuloma annulare.
Typical NLD of the lower extremities shows central epidermal atrophy, prominent vessels, lipid deposition in the subcutaneous tissue giving a yellowish appearance.
There is frequently an inflammatory edge which slowly expands peripherally. The center of the atrophic area can ulcerate.

Treatment:

• Stop smoking
• ase reports on the use of nicotinamide, chlorphazamine, topical tretinoin, cyclosporine and topical PUVA

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