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Necrobiosis lipoidica diabeticorum: Response to pentoxiphylline

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Abstract

Necrobiosis lipoidica diabeticorum (NLD) is a condition that can be physically and psychologically distressing. Angiopathy leading to thrombosis and occlusion of the cutaneous vessels has been implicated in its etiology. Pentoxiphylline is a hemorrheological agent that improves blood flow and decreases red cell and platelet aggregation. Based on these data, aim of our study was to report clinical course of a 20-yr-old diabetic woman with NLD during therapy with Pentoxiphylline 400 mg 3 times daily. After 1 month of therapy, the lesions stopped enlarging. After 3 months, the lesions showed initial signs of healing. At 6-month follow-up, there was near resolution of the lesions. The patient continued therapy and remained in remission at 2-yr follow-up. This improvement relieved psychological stress on the patient. No side effects of treatment were reported.

In conclusion, patients with NLD may benefit from treatment with pentoxiphylline. We recommend therapy with 400 mg 3 times daily. The drug should be continued for at least 6 months.

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References

  1. Muller SA, Winkelmann RK. Necrobiosis lipoidica diabeticorum. A clinical and pathological investigation of 171 cases. Arch Dermatol 1966, 93: 272–81.

    Article  CAS  PubMed  Google Scholar 

  2. Oppenheim M. Eigentumlich disseminierte degeneration des bindegewebes der haut bie einem diabetiker. Z Hautkr 1929, 32: 179.

    Google Scholar 

  3. Quimby SR, Muller SA, Schroeter AL. The cutaneous immunopathology of necrobiosis lipoidica diabeticorum. Arch Dermatol 1988, 124: 1364–71.

    Article  CAS  PubMed  Google Scholar 

  4. Lowitt MH, Dover JS. Necrobiosis lipoidica. J Am Acad Dermatol 1991, 25: 735–48.

    Article  CAS  PubMed  Google Scholar 

  5. Campbell RK. Clinical update on pentoxiphylline therapy for diabetes-induced peripheral vascular disease. Ann Pharmacother 1993, 27: 1099–105.

    CAS  PubMed  Google Scholar 

  6. Littler CM, Tschen EH. Pentoxiphylline for necrobiosis lipoidica diabeticorum. J Am Acad Dermatol 1987, 17: 314–6.

    Article  CAS  PubMed  Google Scholar 

  7. Noz KC, Korstanje MJ, Vermeer BJ. Ulcerating necrobiosis lipoidica effectively treated with pentoxiphylline. Clin Exp Dermatol 1993, 18: 78–9.

    Article  CAS  PubMed  Google Scholar 

  8. Laukkanen A, Fraki JE, Vaatainen N, Korhonen T, Naukkarinen A. Necrobiosis lipoidica: clinical and immunofluorescent study. Dermatologica 1986, 172: 89–92.

    Article  CAS  PubMed  Google Scholar 

  9. Dubin BJ, Kaplan EN. The surgical treatment of necrobiosis lipoidica diabeticorum. Plast Reconstr Surg 1977, 60: 421–8.

    CAS  PubMed  Google Scholar 

  10. Marr TJ, Traisman HS, Griffith BH, Schafer MA. Necrobiosis lipoidica diabeticorum in a juvenile diabetic: treatment by excision and skin grafting. Cutis 1977, 19: 348–50.

    CAS  PubMed  Google Scholar 

  11. Rhodes EL. Necrobiosis lipoidica treated with ticlopidine. Acta Derm Venereol 1986, 66: 458.

    CAS  PubMed  Google Scholar 

  12. Fjellner B. Treatment of diabetic necrobiosis with aspirin or dipyridamole. N Engl J Med 1978, 299: 1366.

    Google Scholar 

  13. Heng MC, Song MK, Heng MK. Healing of necrobiotic ulcers with antiplatelet therapy. Correlation with plasma thromboxane levels. Int J Dermatol 1989, 28: 195–7.

    Article  CAS  PubMed  Google Scholar 

  14. Statham B, Finlay AY, Marks R. A randomized double blind comparison of an aspirin dipyridamole combination versus a placebo in the treatment of necrobiosis lipoidica. Acta Derm Venereol 1981, 61: 270–1.

    CAS  PubMed  Google Scholar 

  15. Hammerschmidt DE, Kotasek D, McCarthy T, Huh PW, Freyburger G, Vercellotti GM. Pentoxiphylline inhibits granulocyte and platelet function, including granulocyte priming by platelet activating factor. J Lab Clin Med 1988, 112: 254–63.

    CAS  PubMed  Google Scholar 

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Correspondence to S. Basaria M.D..

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Basaria, S., Braga-Basaria, M. Necrobiosis lipoidica diabeticorum: Response to pentoxiphylline. J Endocrinol Invest 26, 1037–1040 (2003). https://doi.org/10.1007/BF03348204

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  • DOI: https://doi.org/10.1007/BF03348204

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