Necrobiosis lipoidica diabeticorum

171 Necrobiosis lipoidica diabeticorum



Instruction


Look at this patient’s legs.


Examine this patient’s back.



Salient features



History




• History of diabetes (according to a recent study from Ireland only a minority of the patients have diabetes; Br J Dermatol 1999;40:283–6).



Examination




• Usually seen in females (two to four times more frequently than in men)


• Sharply demarcated oval plaques seen on the shin (Fig. 171.1), arms or back


• The plaques have a shiny surface with yellow waxy atrophic centres and brownish red margins with surrounding telangiectasia.


image

Fig. 171.1 Necrobiosis lipoidica diabeticorum. Well-demarcated, waxy erythematous plaques with prominent telangiectasias.


Proceed as follows:



• Tell the examiner that you would like to check the urine for sugar.



Diagnosis


This patient has plaques with yellow waxy centres on the shins (lesions) caused by diabetes mellitus (aetiology); the lesions are cosmetically disfiguring (functional status).


Remember: In necrobiosis lipoidica diabeticorum, although the shins, ankles and feet are typically affected, 15% of patients may have lesions elsewhere.

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  3. Vitiligo
  4. Anaemia

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Dec 4, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Necrobiosis lipoidica diabeticorum

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