Necrobiosis Lipoidica
Necrobiosis Lipoidica Diabeticorum (NLD)
Epidemiology and Etiology:
- 2/3 of patients
have DM
- 1% of DM
patients get NLD
- F:M = 3:1
- etiology not fully
understood
- microangiopathic changes
- immune-complex-mediated
vasculitis
- thrombotic tendency
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Common sites:
Gross features:
- patches or plaques
- waxy
- indurated
- yellow-brown
- surrounding erythematous, raised, expanding margin
Histologic features:
- palisaded granulomas
- involving full-thickness
demis, and often subcutaneous fat
- horizontal and
parallel arrangement with respect to epidermis
- marked collagen
degeneration at centre without connective tissue mucin
- fibrotic dermis at periphery of palisaded area
- lipid deposition
sometimes
- superficial and
deep perivascular lymphoplasmacytic
infiltrate
- may see:
- vasculitis (leukocytoclastic
/ granulomatous)
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
References: