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Necrobiosis lipoidica

Karolyn Wanat, MD
Misha Rosenbach, MD
Section Editor
Jeffrey Callen, MD, FACP, FAAD
Deputy Editor
Abena O Ofori, MD


Necrobiosis lipoidica is a rare, chronic granulomatous disease of the skin. Skin involvement usually begins as red-brown or violaceous papules or nodules and progresses to yellow-brown, atrophic, telangiectatic plaques (picture 1A-E). The lower legs, especially the shins, are the most common sites of involvement. Ulceration is a common complication (picture 1F).

Necrobiosis lipoidica frequently occurs in association with diabetes mellitus, which accounts for the past use of the term "necrobiosis lipoidica diabeticorum" for this disease. The recognition that necrobiosis lipoidica also occurs in the absence of diabetes led to the change in terminology.

The treatment of necrobiosis lipoidica can be challenging. Topical or intralesional administration of corticosteroids is often used as initial therapy.

The clinical manifestations, diagnosis, and management of necrobiosis lipoidica will be reviewed here.


Necrobiosis lipoidica is a rare disorder that primarily affects young and middle-aged adults but can also occur in children and the elderly. In a retrospective study of 171 patients with necrobiosis lipoidica, the average age of onset for patients with diabetes-associated necrobiosis lipoidica was 25 years, and the average age of onset for patients with nondiabetes-associated necrobiosis lipoidica was 46 years [1]. In a separate retrospective study of 100 patients with necrobiosis lipoidica, the median age at the time of evaluation was 52 years [2].

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Literature review current through: Sep 2017. | This topic last updated: Nov 10, 2016.
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