Necrobiosis Lipoidica

Key Points
Rare skin condition typically affecting the shin
Cause is unknown, but may occur in conjunction with diabetes
Consists of the development of yellow-brown patches of skin which are tender and irregular in shape

Necrobiosis lipoidica is a rare skin condition which affects the shin. It consists of the development of yellow-brown patches of skin which are tender and often irregular in shape, though they may be oval or round, and are not accompanied by other symptoms. Paling, shiny skin in the center of the lesion becomes thin and covered with visible blood vessels. Injury may cause the area to ulcerate in some cases. Lesion development may take a few months, and lesions may be persistent for years.

The cause of necrobiosis lipoidica is unknown, though in some cases it may occur in conjunction with diabetics who are insulin dependent.

Differential Diagnosis (Other conditions with similar appearance)
Granuloma annulare
Sarcoidosis
Xanthomas

Diagnosis
Key Points
Initial diagnosis based on appearance of lesions
Skin biopsy may be recommended to confirm diagnosis

Necrobiosis lipoidica is initially diagnosed based on the appearance of lesions, at which point a skin biopsy is performed to confirm diagnosis.

Treatment
Some cases do not require treatment
*If required, treatment may come in various forms

Some cases of necrobiosis lipoidica do not require treatment, but in those that do, several treatment options exist. These include the use of topical steroids, intralesional steroid Injections, oral ciclosporin, photochemotherapy, aspirin/idpyridamole cocktail, or oxypentifylline.