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Abstract

Necrobiosis lipoidica (NBL) presents as solitary or multiple chronic granulomatous infiltrative lesions of unknown etiology in the dermis of predominantly female patients. It has a higher prevalence in diabetic patients, but the association between NBL and diabetes is debated.

Microangiopathy and tissue hypoxia may play a leading role in the pathogenesis; ulceration and infection may contribute to persistence. Possibility of genetic predisposition might be of importance as well as oncogene expression. Treatment is difficult, often resulting only in partial response and frequent relapses. Topically applied steroids or calcineurin inhibitors in combination with compression serve as baseline therapy, while various forms of phototherapy come as second line. New approaches emerge, such as photodynamic therapy and fractional laser therapy, local fumaric acid ester, intravenous immunoglobulin, and systemic targeted therapy with biologicals, but their effectiveness needs to be further evaluated.

Keywords

Necrobiosis lipoidica Necrobiosis lipoidica diabeticorum Granulomatous disease Diabetes mellitus Exulceration Combination treatment Therapy resistance 

Abbreviations

DM

Diabetes mellitus

NBL

Necrobiosis lipoidica

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Dermatology, Clinical CenterUniversity of DebrecenDebrecenHungary

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