Necrobiosis Lipoidica

Excerpt

Necrobiosis lipoidica (NL) is a rare, chronic, and idiopathic granulomatous disease of collagen degeneration. It has an associated risk of ulceration and is classically associated with diabetes mellitus, usually type 1. There is a thickening of the blood vessels' walls and fat deposition. The major complication of the disease is the formation of an ulcer, mainly occurring after trauma. Uncommonly, infections can also occur. Moreover, if necrobiosis lipoidica becomes chronic, it may rarely turn into squamous cell carcinoma.

Necrobiosis lipoidica was first mentioned as dermatitis atrophicans lipoidica diabetica in 1929 by Oppenheim. However, in 1932, Urbach renamed the disease necrobiosis lipoidica diabeticorum (NLD).

In 1935, the first case was reported by Goldsmith in a nondiabetic patient. Subsequently, more cases of NLD were described by Meischer and Leder in nondiabetic patients in 1948. In 1960, Rollins and Winkelmann also published about NLD in nondiabetic patients. Hence, the suggestion to exclude diabetes from the name of the disease was put forward. Today, a broader term, necrobiosis lipoidica, encompasses all patients with the same clinical lesions without considering the presence or absence of diabetes.