Necrobiosis lipoidica is a rare granulomatous dermatosis. It occurs in 0.3-1.2% of diabetic patients mainly at the level of the leg. The lesions appear as erythematous plaques with central depressions. We here report the case of a 21-year old female patient with a 6-year history of type 1 diabetes presenting with a 1-year history of well circumscribed, symmetrical and asymptomatic erythematous plaques with atrophic yellowish center at the level of the anterior compartments of the legs (A, B). The diagnosis of necrobiosis lipoidica was suspected, a biopsy was performed which confirmed the diagnosis. The patient had a granulomatous inflammatory reaction with palisade-like border disposed around poorly delimited foci of altered connective tissue on the entire dermis layer. The inflammatory reaction was also characterized by multinucleate giant cells, dendrocytes and lipid deposits. Local corticosteroid therapy was prescribed. Patient's evolution was marked by the persistence of the lesions.
Keywords: Necrobiosis lipoidica; granulomatous dermatosis; type 1 diabetes.