Tags

Type your tag names separated by a space and hit enter

Necrobiosis Lipoidica Diabeticorum: A pediatric case report.
Dermatoendocrinol. 2014 Jan 01; 6(1):e27790.D

Abstract

INTRODUCTION

Necrobiosis lipoidica (NL) is a rare chronic granulomatous dermatitis that usually appears in the lower extremities. It affects about 0.3-1.2% of diabetic patients, the majority of whom have type 1 diabetes. The etiology and pathogenesis of this disorder are still unclear. NL is characterized by skin rash that usually affects the shins. The average onset is 30 years, with females being affected more commonly. There are very few reported cases of necrobiosis lipoidica in children.

CASE REPORT

We report a case of a 16 year old girl affected by type 1 diabetes mellitus (15 years disease duration) who developed an erythematous nodular rash on the lower extremities and interscapular area. In the suspect of necrobiosis lipoidica, a skin biopsy was performed (lower extremities and interscapular area). The microscopic evaluation of the pretibial lesions was suggestive of necrobiosis lipoidica. The smaller lesions in the interscapular area showed signs of perivascular dermatitis which could be consistent with early stages of necrobiosis lipoidica. Local treatment with tacrolimus determined a progressive improvement of the lesions.

CONCLUSION

In patients with T1DM, diagnosis of NL of the lower legs is usually unequivocal. However, diagnosis may be more challenging in the presence of lesions with recent onset and/or atypical clinical presentation and unusual site. In these cases, NL must always be taken in consideration in order to avoid misdiagnosis, wrong/late treatment decisions and progression to ulceration.

Authors+Show Affiliations

Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Osp. Maggiore Policlinico; Department of Pathophysiology and Transplantation; Milano, Italy.Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Osp. Maggiore Policlinico; Department of Pathophysiology and Transplantation; Milano, Italy.Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Osp. Maggiore Policlinico; Department of Pathophysiology and Transplantation; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.Ospedale San Raffaele Scientific Institute; Department of Pediatrics; Milano, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24575162

Citation

Bonura, Clara, et al. "Necrobiosis Lipoidica Diabeticorum: a Pediatric Case Report." Dermato-endocrinology, vol. 6, no. 1, 2014, pp. e27790.
Bonura C, Frontino G, Rigamonti A, et al. Necrobiosis Lipoidica Diabeticorum: A pediatric case report. Dermatoendocrinol. 2014;6(1):e27790.
Bonura, C., Frontino, G., Rigamonti, A., Battaglino, R., Favalli, V., Ferro, G., Rubino, C., Del Barba, P., Pesapane, F., Nazzaro, G., Gianotti, R., Bonfanti, R., Meschi, F., & Chiumello, G. (2014). Necrobiosis Lipoidica Diabeticorum: A pediatric case report. Dermato-endocrinology, 6(1), e27790. https://doi.org/10.4161/derm.27790
Bonura C, et al. Necrobiosis Lipoidica Diabeticorum: a Pediatric Case Report. Dermatoendocrinol. 2014 Jan 1;6(1):e27790. PubMed PMID: 24575162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Necrobiosis Lipoidica Diabeticorum: A pediatric case report. AU - Bonura,Clara, AU - Frontino,Giulio, AU - Rigamonti,Andrea, AU - Battaglino,Roseila, AU - Favalli,Valeria, AU - Ferro,Giusy, AU - Rubino,Chiara, AU - Del Barba,Paolo, AU - Pesapane,Filippo, AU - Nazzaro,Gianluca, AU - Gianotti,Raffaele, AU - Bonfanti,Riccardo, AU - Meschi,Franco, AU - Chiumello,Giuseppe, Y1 - 2014/01/17/ PY - 2013/11/25/received PY - 2014/01/09/accepted PY - 2014/2/28/entrez PY - 2014/2/28/pubmed PY - 2014/2/28/medline KW - T1DM KW - children KW - diabetes KW - granulomatous dermatitis KW - necrobiosis lipoidica KW - skin lesion KW - type 1 diabetes SP - e27790 EP - e27790 JF - Dermato-endocrinology JO - Dermatoendocrinol VL - 6 IS - 1 N2 - INTRODUCTION: Necrobiosis lipoidica (NL) is a rare chronic granulomatous dermatitis that usually appears in the lower extremities. It affects about 0.3-1.2% of diabetic patients, the majority of whom have type 1 diabetes. The etiology and pathogenesis of this disorder are still unclear. NL is characterized by skin rash that usually affects the shins. The average onset is 30 years, with females being affected more commonly. There are very few reported cases of necrobiosis lipoidica in children. CASE REPORT: We report a case of a 16 year old girl affected by type 1 diabetes mellitus (15 years disease duration) who developed an erythematous nodular rash on the lower extremities and interscapular area. In the suspect of necrobiosis lipoidica, a skin biopsy was performed (lower extremities and interscapular area). The microscopic evaluation of the pretibial lesions was suggestive of necrobiosis lipoidica. The smaller lesions in the interscapular area showed signs of perivascular dermatitis which could be consistent with early stages of necrobiosis lipoidica. Local treatment with tacrolimus determined a progressive improvement of the lesions. CONCLUSION: In patients with T1DM, diagnosis of NL of the lower legs is usually unequivocal. However, diagnosis may be more challenging in the presence of lesions with recent onset and/or atypical clinical presentation and unusual site. In these cases, NL must always be taken in consideration in order to avoid misdiagnosis, wrong/late treatment decisions and progression to ulceration. SN - 1938-1972 UR - https://www.unboundmedicine.com/medline/citation/24575162/Necrobiosis_Lipoidica_Diabeticorum:_A_pediatric_case_report_ L2 - http://www.tandfonline.com/doi/full/10.4161/derm.27790 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.