Necrobiosis lipoidica (NL) is a cutaneous disorder often, but not always, associated with diabetes mellitus. The lesions are distinctive, sharply circumscribed, multicolored plaques occurring on the anterior and lateral surfaces of the lower legs.
It is more common in women, and there are usually several spots. They are slightly raised shiny red-brown patches. The centers are often yellowish and may develop open sores that are slow to heal.
The arteriolar changes in the areas of necrobiosis of the collagen have been thought by some to be precipitated by aggregation of platelets. The granulomatous inflammatory reaction is believed to be due to alterations in the collagen. The severity of NL is not related to the severity of the diabetes mellitus. Furthermore, control of the diabetes has no effect on the course of NL.
Usually there are none. The main problem lies in the rather ugly appearance of the discoloured areas. In addition, the skin there is easily broken and heals poorly, so that even minor knocks can lead to painful ulcers.
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