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The role of anti-tumour necrosis factor in wound healing: A case report of refractory ulcerated necrobiosis lipoidica treated with adalimumab and review of the literature.
SAGE Open Med Case Rep. 2019; 7:2050313X19881594.SO

Abstract

Necrobiosis lipoidica is a chronic granulomatous disease historically associated with diabetes. Necrobiosis lipoidica commonly presents with erythematous papules or plaques on the anterior lower extremities, which can be ulcerated in up to 30% of patients. The pathophysiology of necrobiosis lipoidica is unknown but proposed to be predominantly linked to microangiopathy. No treatment option for necrobiosis lipoidica has shown consistent efficacy. Previous case reports have shown immune-modulating agents to be reasonable treatment options for ulcerative necrobiosis lipoidica. However, evidence for the tumour necrosis factor-alpha inhibitor, adalimumab, is limited and contradictory. We report a case of a 74-year-old type 2 diabetic female with a 2-year history of multiple ulcerated necrobiosis lipoidica plaques resistant to topical and systemic therapy. Treatment with adalimumab showed complete re-epithelization of all ulcers by week 28. Adalimumab may be an effective treatment option for ulcerated necrobiosis lipoidica that has failed traditional therapies. Further reports of adalimumab treatment of necrobiosis lipoidica and other chronic inflammatory wounds are needed.

Authors+Show Affiliations

Faculty of Medicine, University of Toronto, Toronto, ON, Canada.Department of Dermatology, University of Toronto, Toronto, ON, Canada. York Dermatology Center, Richmond Hill, ON, Canada.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31666953

Citation

Sandhu, Vijay Kumari, and Afsaneh Alavi. "The Role of Anti-tumour Necrosis Factor in Wound Healing: a Case Report of Refractory Ulcerated Necrobiosis Lipoidica Treated With Adalimumab and Review of the Literature." SAGE Open Medical Case Reports, vol. 7, 2019, p. 2050313X19881594.
Sandhu VK, Alavi A. The role of anti-tumour necrosis factor in wound healing: A case report of refractory ulcerated necrobiosis lipoidica treated with adalimumab and review of the literature. SAGE open medical case reports. 2019;7:2050313X19881594.
Sandhu, V. K., & Alavi, A. (2019). The role of anti-tumour necrosis factor in wound healing: A case report of refractory ulcerated necrobiosis lipoidica treated with adalimumab and review of the literature. SAGE Open Medical Case Reports, 7, 2050313X19881594. https://doi.org/10.1177/2050313X19881594
Sandhu VK, Alavi A. The Role of Anti-tumour Necrosis Factor in Wound Healing: a Case Report of Refractory Ulcerated Necrobiosis Lipoidica Treated With Adalimumab and Review of the Literature. SAGE open medical case reports. 2019;7:2050313X19881594. PubMed PMID: 31666953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of anti-tumour necrosis factor in wound healing: A case report of refractory ulcerated necrobiosis lipoidica treated with adalimumab and review of the literature. AU - Sandhu,Vijay Kumari, AU - Alavi,Afsaneh, Y1 - 2019/10/18/ PY - 2019/11/1/entrez PY - 2019/11/2/pubmed PY - 2019/11/2/medline KW - Necrobiosis lipoidica KW - adalimumab KW - biologic agents KW - tumour necrosis factor-alpha KW - wound healing SP - 2050313X19881594 EP - 2050313X19881594 JF - SAGE open medical case reports VL - 7 N2 - Necrobiosis lipoidica is a chronic granulomatous disease historically associated with diabetes. Necrobiosis lipoidica commonly presents with erythematous papules or plaques on the anterior lower extremities, which can be ulcerated in up to 30% of patients. The pathophysiology of necrobiosis lipoidica is unknown but proposed to be predominantly linked to microangiopathy. No treatment option for necrobiosis lipoidica has shown consistent efficacy. Previous case reports have shown immune-modulating agents to be reasonable treatment options for ulcerative necrobiosis lipoidica. However, evidence for the tumour necrosis factor-alpha inhibitor, adalimumab, is limited and contradictory. We report a case of a 74-year-old type 2 diabetic female with a 2-year history of multiple ulcerated necrobiosis lipoidica plaques resistant to topical and systemic therapy. Treatment with adalimumab showed complete re-epithelization of all ulcers by week 28. Adalimumab may be an effective treatment option for ulcerated necrobiosis lipoidica that has failed traditional therapies. Further reports of adalimumab treatment of necrobiosis lipoidica and other chronic inflammatory wounds are needed. SN - 2050-313X UR - https://www.unboundmedicine.com/medline/citation/31666953/The_role_of_anti_tumour_necrosis_factor_in_wound_healing:_A_case_report_of_refractory_ulcerated_necrobiosis_lipoidica_treated_with_adalimumab_and_review_of_the_literature_ L2 - https://journals.sagepub.com/doi/10.1177/2050313X19881594?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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