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Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients.
Int Wound J. 2015 Oct; 12(5):548-54.IW

Abstract

Necrobiosis lipoidica is a rare granulomatous disorder of the skin. In up to 30% of the affected patients it can lead to ulcerations, which can impair the quality of life and are also very difficult to treat. Its pathogenesis is not fully understood. Only few studies focussing on necrobiosis lipoidica can be found, but none of them focus on ulcerated necrobiosis lipoidica. Therefore, we collected demographic data and comorbidities and assessed treatment options for patients with ulcerated necrobiosis lipoidica. Data of patients who were treated in the wound care centre of the University Hospital of Essen for ulcerated necrobiosis lipoidica over the past 10 years were retrospectively analysed. Hence, data of altogether ten patients (nine women and one man) with ulcerated necrobiosis lipoidica were collected. Of these, 70% of the patients had diabetes mellitus of which 30% had type I diabetes and 40% had type II diabetes; 60% of the patients suffered from arterial hypertension, obesity and hypercholesterolaemia; 40% of the patients suffered from psychiatric disorders such as depression and borderline disorder. Our clinical data demonstrate an association of ulcerated necrobiosis lipoidica and aspects of metabolic syndrome. This leads to a conclusion that ulcerating necrobiosis lipoidica can be seen as part of a generalised inflammatory reaction similar to the inflammatory reaction already known in the pathophysiology of rheumatoid diseases or psoriasis. In patients with clinical atypical painful ulcerations, necrobiosis lipoidica should be considered as a possible differential diagnosis. Therapists should be aware of associated aspects in patients with ulcerated necrobiosis lipoidica who besides diabetes often suffer from other aspects of a metabolic syndrome with increased cardiovascular risk factors. Therefore, these related comorbidities should also be diagnosed and treated.

Authors+Show Affiliations

Department of Dermatology, Venereology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Department of Dermatology, Venereology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Department of Dermatology, Venereology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Department of Dermatology, Venereology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24119190

Citation

Franklin, Cindy, et al. "Ulcerated Necrobiosis Lipoidica as a Rare Cause for Chronic Leg Ulcers: Case Report Series of Ten Patients." International Wound Journal, vol. 12, no. 5, 2015, pp. 548-54.
Franklin C, Stoffels-Weindorf M, Hillen U, et al. Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients. Int Wound J. 2015;12(5):548-54.
Franklin, C., Stoffels-Weindorf, M., Hillen, U., & Dissemond, J. (2015). Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients. International Wound Journal, 12(5), 548-54. https://doi.org/10.1111/iwj.12159
Franklin C, et al. Ulcerated Necrobiosis Lipoidica as a Rare Cause for Chronic Leg Ulcers: Case Report Series of Ten Patients. Int Wound J. 2015;12(5):548-54. PubMed PMID: 24119190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients. AU - Franklin,Cindy, AU - Stoffels-Weindorf,Maren, AU - Hillen,Uwe, AU - Dissemond,Joachim, Y1 - 2013/10/07/ PY - 2013/05/10/received PY - 2013/08/20/accepted PY - 2013/10/15/entrez PY - 2013/10/15/pubmed PY - 2016/7/9/medline KW - Chronic wound KW - Diabetes mellitus KW - Leg ulcer KW - Metabolic syndrome KW - Necrobiosis lipoidica SP - 548 EP - 54 JF - International wound journal JO - Int Wound J VL - 12 IS - 5 N2 - Necrobiosis lipoidica is a rare granulomatous disorder of the skin. In up to 30% of the affected patients it can lead to ulcerations, which can impair the quality of life and are also very difficult to treat. Its pathogenesis is not fully understood. Only few studies focussing on necrobiosis lipoidica can be found, but none of them focus on ulcerated necrobiosis lipoidica. Therefore, we collected demographic data and comorbidities and assessed treatment options for patients with ulcerated necrobiosis lipoidica. Data of patients who were treated in the wound care centre of the University Hospital of Essen for ulcerated necrobiosis lipoidica over the past 10 years were retrospectively analysed. Hence, data of altogether ten patients (nine women and one man) with ulcerated necrobiosis lipoidica were collected. Of these, 70% of the patients had diabetes mellitus of which 30% had type I diabetes and 40% had type II diabetes; 60% of the patients suffered from arterial hypertension, obesity and hypercholesterolaemia; 40% of the patients suffered from psychiatric disorders such as depression and borderline disorder. Our clinical data demonstrate an association of ulcerated necrobiosis lipoidica and aspects of metabolic syndrome. This leads to a conclusion that ulcerating necrobiosis lipoidica can be seen as part of a generalised inflammatory reaction similar to the inflammatory reaction already known in the pathophysiology of rheumatoid diseases or psoriasis. In patients with clinical atypical painful ulcerations, necrobiosis lipoidica should be considered as a possible differential diagnosis. Therapists should be aware of associated aspects in patients with ulcerated necrobiosis lipoidica who besides diabetes often suffer from other aspects of a metabolic syndrome with increased cardiovascular risk factors. Therefore, these related comorbidities should also be diagnosed and treated. SN - 1742-481X UR - https://www.unboundmedicine.com/medline/citation/24119190/Ulcerated_necrobiosis_lipoidica_as_a_rare_cause_for_chronic_leg_ulcers:_case_report_series_of_ten_patients_ L2 - https://doi.org/10.1111/iwj.12159 DB - PRIME DP - Unbound Medicine ER -