Necrobiosis Lipoidica
Enhanced expression of human metalloelastase (MMP-12) in cutaneous granulomas and macrophage migration. (1/10)
Accumulation of inflammatory cells such as macrophages may lead to degeneration of connective tissue matrix in various skin diseases. Macrophage metalloelastase, is a matrix metalloproteinase (MMP-12) capable of degrading elastin as well as various basement membrane components. To investigate the role of human macrophage metalloelastase in skin, we assessed by in situ hybridization and immunohistochemistry 66 specimens representing skin diseases characterized either by changes in elastic fibers or by pronounced infiltrations of extravasating and migrating macrophages. CD68 immunostaining was performed to identify the human macrophage metalloelastase-positive cells and Weigert's Resorcin-Fuchsin staining to reveal the status of elastic fibers. We found abundant expression of human macrophage metalloelastase mRNA in macrophages in areas devoid of normal elastic fibers in granulomatous skin diseases sarcoidosis, necrobiosis lipoidica diabeticorum, and granuloma annulare. Positive cells for human macrophage metalloelastase protein could be detected in the same regions as well as positive immunostaining for urokinase plasminogen activator. Of the other matrix metalloproteinases capable of degrading elastin, 92 kDa gelatinase colocalized with human macrophage metalloelastase, while 72 kDa gelatinase was produced by surrounding fibroblast-like cells. Furthermore, human macrophage metalloelastase was expressed by macrophages in areas with disrupted basement membrane, as assessed by type IV collagen staining, in pityriasis lichenoides and dermatitis herpetiformis. Specimens of anetoderma, acrodermatitis chronica atrophicans and pseudoxanthoma elasticum showed no signal for human macrophage metalloelastase. Matrilysin was not detected in any of the samples investigated. Our study suggests that human macrophage metalloelastase may contribute to elastin degradation occurring in granulomatous skin diseases and may aid macrophage migration through the epidermal and vascular basement membranes in inflammatory disorders. (+info)Necrobiosis lipoidica. (2/10)
A 68-year-old woman presented with a 3-year history of asymptomatic, yellow-brown plaques on the lower extremities with trauma-related superficial ulcers. A biopsy specimen was consistent with necrobiosis lipoidica. Necrobiosis lipoidica is a chronic granulomatous dermatitis that is associated with diabetes mellitus; however, its pathogenesis remains unclear. Topical glucocorticoids are first-line therapy; however, no treatment has proven efficacy in double-blind, placebo-controlled studies. (+info)Periorbital necrobiosis lipoidica. (3/10)
Necrobiosis lipoidica is a granulomatous skin condition typically occurring on the legs. A patient with this condition presented with gross bilateral induration of the eyelids sufficient to close both eyes. (+info)Familial necrobiosis lipoidica not associated with diabetes. (4/10)
A 42-year-old woman presented with a 12-year history of extensive yellow and erythematous plaques, round and oblong with irregular configuration and glossy atrophic central areas on the pretibial aspects of both legs. Her 45-year-old sister presented with a 7-year history of a single plaque with erythematous margins, abundant telangiectases, and an atrophic center in the lower portion of the left leg. There was no family history of type-1 or type-2 diabetes mellitus. Both patients had normal fasting glucose concentration, oral glucose tolerance test, and glucose overload test. Different treatment options including topical corticosteroids were unsuccessful. Treatment with oral fumaric acid esters was attempted but the medication was discontinued because of intolerable side effects (flushing and gastrointestinal discomfort). At present, after a follow-up of 2 years, the plaques remain unchanged. These two cases should be added to the few cases of familial nondiabetic necrobiosis lipoidica previously reported. (+info)A case of perforating necrobiosis lipoidica in an African American female. (5/10)
An African American female with type II diabetes of 4 years duration presents with a 3-year history of smooth firm, dark brown plaques focally studded with comedone-like papules. Clinically and histologically her lesions were consistent with the rare entity perforating necrobiosis lipoidica. (+info)Perforating necrobiosis lipoidica in a girl with type 1 diabetes mellitus: a new case reported. (6/10)
Necrobiosis lipoidica is an idiopathic dermatological condition that is strongly associated with diabetes mellitus. It is more commonly seen in women than men. The average age of onset is 30-40 years. Necrobiosis Lipoidica diabeticorum is an extremely rare finding in childhood diabetes. We describe the case of a 13-year-old girl who has had type 1 diabetes mellitus since she was 8 years old. The patient presented with 2 well-defined, persistent plaques with a depressed central area and elevated purple peripheral ring, one on the right thigh and the other over the lateral left leg. Histopathologic evaluation of the patient's biopsy confirmed the diagnosis of necrobiosis lipoidica with transfollicular elimination. Our patient is the second pediatric case described with perforating necrobiosis lipoidica. We review the literature and discuss clinical features, several complications, and the most recent treatment options for necrobiosis lipoidica in diabetic children. (+info)Necrobiosis lipoidica. (7/10)
A 58-year-old woman presented with a seven-year history of an eruption on her lower legs that was associated with edema, weeping, pruritus, and a burning sensation. Past medical history included Hashimoto thyroiditis, which was diagnosed eight years prior to presentation. Histopathologic examination was consistent with necrobiosis lipoidica (NL). To our knowledge, NL that is associated with Hashimoto thyroiditis has been described in only one prior report. NL is a chronic, cutaneous, granulomatous condition with degenerative connective-tissue changes of unknown etiology. Our patient responded well to a potent topical glucocorticoid and topical tretinoin. Although our patient did not have diabetes mellitus, 75 percent of patients with NL have diabetes mellitus at the time of diagnosis or will subsequently develop diabetes mellitus. This association with diabetes mellitus mandates screening for glucose intolerance in all patients with NL. (+info)Simultaneous occurrence of ulcerated necrobiosis lipoidica and granuloma annulare in a patient: case report. (8/10)
(+info)Necrobiosis lipoidica is a rare skin condition characterized by the formation of well-circumscribed, yellowish or brownish, slightly depressed plaques with a rolled border, often occurring on the shins. The lesions may be asymptomatic or tender and can ulcerate.
Histologically, it is marked by granulomatous inflammation with degeneration of collagen in the dermis (necrobiosis) and an accumulation of lipid-laden macrophages (lipoidosis). The exact cause of necrobiosis lipoidica is unknown, but it is often associated with diabetes mellitus. It primarily affects middle-aged women and can precede the diagnosis of diabetes. Treatment options include corticosteroids, immunomodulatory agents, and phototherapy, but the condition can be resistant to treatment and may require long-term management.
Necrobiotic disorders are a group of medical conditions characterized by the presence of necrosis (tissue death) and inflammation in various organs and tissues. These disorders can be caused by different underlying etiologies, including infections, autoimmune diseases, vasculitis, and malignancies.
One example of a necrobiotic disorder is necrobiosis lipoidica, which primarily affects the skin. It is a chronic inflammatory condition that typically presents as one or more well-circumscribed, yellowish-brown plaques with central atrophy and telangiectasia, often located on the lower legs. The lesions may be asymptomatic or tender to the touch, and they can ulcerate in some cases.
Another example is necrotizing fasciitis, a rapidly progressive and potentially life-threatening infection that involves the fascia and subcutaneous tissue. It is often caused by group A Streptococcus or other bacterial pathogens and requires prompt surgical intervention and antibiotic therapy to prevent further spread of the infection and potential sepsis.
Other necrobiotic disorders include necrotizing vasculitis, which affects blood vessels and can lead to tissue damage and organ dysfunction, and necrobiotic xanthogranuloma, a rare inflammatory condition that primarily affects the skin but can also involve other organs such as the eyes, kidneys, and liver.
Overall, necrobiotic disorders are complex medical conditions that require careful evaluation and management by healthcare professionals with expertise in the relevant fields.
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Diabeticorum20
- In the former case it may be called necrobiosis lipoidica diabeticorum (NLD). (wikipedia.org)
- Necrobiosis lipoidica diabeticorum is an uncommon skin condition related to diabetes . (medlineplus.gov)
- The cause of necrobiosis lipoidica diabeticorum (NLD) is unknown. (medlineplus.gov)
- Other cases of necrobiosis lipoidica diabeticorum in nondiabetic patients were described by Meischer and Leder, in 1948. (medscape.com)
- Because of the strong relationship between diabetes and necrobiosis lipoidica diabeticorum, many studies have focused on diabetic microangiopathy as the leading etiologic theory. (medscape.com)
- Necrobiosis lipoidica diabeticorum is a chronic skin disease characterized by shiny plaques that vary in color from light yellowish to reddish-tan. (medlineplus.gov)
- In 1932 Urbach coined the term necrobiosis lipoidica diabeticorum for this disease because it was first described in patients with DM. (racgp.org.au)
- Inasmuch as necrobiosis lipoidica diabeticorum is difficult to treat, I feel justified in reporting the response of a single case to injections of hydrocortisone suspension. (jamanetwork.com)
- Clinical appearance and biopsy were those of necrobiosis lipoidica diabeticorum. (jamanetwork.com)
- Pretibial diabetic skin changes: necrobiosis lipoidica diabeticorum. (5minuteconsult.com)
- Necrobiosis lipoidica diabeticorum (NLD) is a rare granulomatous skin disorder that has a female predominance, with an approximate ratio of 3:1. (ssdds.org)
- The patient was diagnosed with necrobiosis lipoidica diabeticorum (NLD), a chronic skin disorder of unknown etiology, characterized by degeneration of collagen, granulomatous inflammation, blood-vessel-wall thickening, and sclerosis in the dermis. (clinicaladvisor.com)
- Alcohol and diabetes Necrobiosis lipoidica diabeticorum Has anybody heard of frozen shoulder (adhesive capsulitis)? (faqs.org)
- And that of course, you know, it's necrobiosis lipoidica diabeticorum. (reachmd.com)
- The sugar spots you are referring to can be diabetic dermopathy or necrobiosis lipoidica diabeticorum. (diethealthclub.com)
- Necrobiosis lipoidica diabeticorum can be itchy and painful, and sometimes the skin starts to crack open. (hellodoctor.com.ph)
- Caused by changes in collagen and fat underneath the skin, necrobiosis lipoidica diabeticorum is similar to diabetic dermopathy but the spots are fewer, larger and deeper. (bronxdermatologist.com)
- With necrobiosis lipoidica diabeticorum, the skin also has a shiny porcelain-like appearance and the affected area itches or feels painful. (bronxdermatologist.com)
- Topical steroids usually take care of necrobiosis lipoidica diabeticorum, but cortisone injections can be used in more difficult cases. (bronxdermatologist.com)
- The colloquial name for necrobiosis lipoidica diabeticorum. (unboundmedicine.com)
Granuloma Annulare2
- Areas of necrobiosis are often more extensive and less well defined than in granuloma annulare. (wikipedia.org)
- Here we review JAK inhibitors currently under investigation for the treatment of alopecia areata, vitiligo, sarcoidosis, necrobiosis lipoidica, granuloma annulare, and systemic lupus erythematosus with a special emphasis on safety and the implications of JAK inhibitors during the novel coronavirus 2019 pandemic. (nih.gov)
Diabetes4
- Necrobiosis lipoidica is a necrotising skin condition that usually occurs in patients with diabetes mellitus but can also be associated with rheumatoid arthritis. (wikipedia.org)
- [ 4 ] Today, the term necrobiosis lipoidica is used to encompass all patients with the same clinical lesions, regardless of whether or not diabetes is present. (medscape.com)
- To describe a case of necrobiosis lipoidica in a patient with type 1 diabetes mellitus, and to discuss differential diagnoses and management. (racgp.org.au)
- Necrobiosis lipoidica (NL) is frequently associated with type I or type II diabetes mellitus. (dermatologyadvisor.com)
Collagen2
- Necrobiosis lipoidica is a disorder of collagen degeneration with a granulomatous response, thickening of blood vessel walls, and fat deposition. (medscape.com)
- it shows granulomatous epithelioid histiocytes arranged in a palisaded fashion around destroyed collagen (necrobiosis). (ssdds.org)
Necrosis1
- NL is diagnosed by a skin biopsy, demonstrating superficial and deep perivascular and interstitial mixed inflammatory cell infiltrate (including lymphocytes, plasma cells, mononucleated and multinucleated histiocytes, and eosinophils) in the dermis and subcutis, as well as necrotising vasculitis with adjacent necrobiosis and necrosis of adnexal structures. (wikipedia.org)
Characteristic1
- At low magnification, lesions of necrobiosis lipoidica have a very characteristic appearance. (medscape.com)
Erythema1
- Miescher radial granulomata have also been described in erythema induratum, necrobiosis lipoidica , Sweet syndrome and Behçet disease. (dermnetnz.org)
Shins1
- Necrobiosis lipoidica is most commonly found on the shins, presenting as a well-defined plaque. (racgp.org.au)
Dermis1
- Grupo de trastornos que se caracterizan por edema, basofilia, y distorsión de los haces de colágeno en la dermis. (bvsalud.org)
Pretibial1
- Most cases of necrobiosis lipoidica occur on the pretibial area, but cases have been reported on the face, scalp, trunk, and upper extremities, where the diagnosis is more likely to be missed. (medscape.com)
Annular2
- Necrobiosis lipoidica (NL) typically presents on the anterior tibial areas and ankles as firm smooth annular plaques. (dermatologyadvisor.com)
- Necrobiosis lipoidica with annular features. (dermatologyadvisor.com)
Etiology2
- Treatment for necrobiosis lipoidica is not very effective, partially because the exact etiology remains unknown. (medscape.com)
- Despite extensive studies, the etiology of necrobiosis lipoidica is still uncertain. (medscape.com)
Legs1
- Because localized trauma can cause necrobiosis lipoidica to ulcerate, protection of the legs with elastic support stockings and leg rest may be helpful. (medscape.com)
Diagnosis2
- Necrobiosis lipoidica presents with a distinctive appearance making it an important clinical diagnosis. (racgp.org.au)
- The lesions observed in the patient are typical, which allowed us to make the clinical diagnosis of necrobiosis lipoidica (NL). (racgp.org.au)
Mechanisms1
- Antiplatelet aggregation therapy with aspirin and dipyridamole has been tried owing to a belief that necrobiosis lipoidica results from platelet-mediated vascular occlusion or immune mechanisms that alter platelet survival. (medscape.com)
Chronic1
- There have been rare reported cases of squamous cell carcinomas developing in chronic lesions of necrobiosis lipoidica. (medscape.com)
Prominent2
- [ 5 ] In nondiabetic patients with necrobiosis lipoidica, the vascular changes are not as prominent. (medscape.com)
- whereas, the granulomatous infiltrates of NL are palisaded and associated with prominent necrobiosis. (dermatologyadvisor.com)
Condition1
- 2) PCS499 to treat ulcerated necrobiosis lipoidica, a rare orphan condition. (investorwire.com)
Aspirin1
- medical citation needed] Although there are some techniques that can be used to diminish the signs of necrobiosis such as low dose aspirin orally, a steroid cream or injection into the affected area, this process may be effective for only a small percentage of those treated. (wikipedia.org)
Topical1
- In the case of one patient, researchers found that topical tapinarof cream demonstrated therapeutic efficacy in nonulcerated necrobiosis lipoidica. (dermatologytimes.com)
Patients1
- Other than seeing it on the skin, are patients symptomatic in any way from necrobiosis? (reachmd.com)
Areas1
- Cholesterol clefts, fibrin, and mucin may also be present in areas of necrobiosis. (wikipedia.org)
Central1
- Necrobiosis lipoidica with central crust. (dermatologyadvisor.com)
Granuloma3
- Areas of necrobiosis are often more extensive and less well defined than in granuloma annulare. (wikipedia.org)
- Granuloma annulare and necrobiosis lipoidica tissue reactions as a manifestation of systemic disease. (thedoctorsdoctor.com)
- Granuloma annulare (GA) and necrobiosis lipoidica (NL) are generally considered to be idiopathic cutaneous palisading granulomatous dermatitides. (thedoctorsdoctor.com)
Diabetic1
- Eldor A, Diaz EG, Naparstek E. Treatment of diabetic necrobiosis with aspirin and dipyridamole. (medscape.com)
Cause of necrobiosis1
- The cause of necrobiosis lipoidica isn't completely clear, but women are more likely to have it than men. (cdc.gov)
Ulcerative necrobiosis1
- Stanway A, Rademaker M, Newman P. Healing of severe ulcerative necrobiosis lipoidica with cyclosporin. (medscape.com)
Cutaneous1
- Boateng B, Hiller D, Albrecht HP, Hornstein OP. Cutaneous microcirculation in pretibial necrobiosis lipoidica. (tangello.com.au)
Granulomatosis1
- Necrobiosis lipoidica granulomatosis. (medscape.com)
Eruptive1
- Atypical case of coexistence polymorphous light eruptions and eruptive lichen planus in a patient with necrobiosis lipoidica. (edu.pl)
Histopathology1
- Pretibial angioplasia: a novel entity encompassing the clinical features of necrobiosis lipoidica and the histopathology of venous insufficiency. (medscape.com)
Rheumatoid1
- Necrobiosis lipoidica is a necrotising skin condition that usually occurs in patients with diabetes mellitus but can also be associated with rheumatoid arthritis. (wikipedia.org)
Systemic1
- Beyond psoriasis, skin-related systemic diseases like necrobiosis lipoidica and livedoid vasculopathy have been linked to cardiovascular risk factors. (teawamutu.net)
Diabetes mellitus3
- Risk factors for necrobiosis lipoidica in Type 1 diabetes mellitus. (medscape.com)
- Necrobiosis lipoidica: only a minority of patients have diabetes mellitus. (thedoctorsdoctor.com)
- Although it is commonly accepted that necrobiosis lipoidica (NL) is associated with diabetes mellitus (DM), there is some controversy regarding the degree of this association. (thedoctorsdoctor.com)
Carcinoma2
- Lim C, Tschuchnigg M, Lim J. Squamous cell carcinoma arising in an area of long-standing necrobiosis lipoidica. (medscape.com)
- Squamous cell carcinoma arising in long-standing necrobiosis lipoidica. (medscape.com)
Clinical3
- The clinical appearance of necrobiosis lipoidica is distinctive, yet there are many atypical presentations, and early forms can be hard to recognize. (medscape.com)
- Updated results of 100 patients on clinical features and therapeutic options in necrobiosis lipoidica in a retrospective multicentre study. (medscape.com)
- Clinical Features and Comorbidities of Patients With Necrobiosis Lipoidica With or Without Diabetes. (medscape.com)
Vasculitis1
- NL is diagnosed by a skin biopsy, demonstrating superficial and deep perivascular and interstitial mixed inflammatory cell infiltrate (including lymphocytes, plasma cells, mononucleated and multinucleated histiocytes, and eosinophils) in the dermis and subcutis, as well as necrotising vasculitis with adjacent necrobiosis and necrosis of adnexal structures. (wikipedia.org)
Medical1
- It is called necrobiosis lipoidica in medical terms. (askinnovativeindia.com)
Data1
- Jockenhofer F, Kroger K, Klode J, Renner R, Erfurt-Berge C, Dissemond J. Cofactors and comorbidities of necrobiosis lipoidica: analysis of the German DRG data from 2012. (medscape.com)
Present1
- Cholesterol clefts, fibrin, and mucin may also be present in areas of necrobiosis. (wikipedia.org)
Cell1
- Depending on the severity of the necrobiosis, certain cell types may be more predominant. (wikipedia.org)