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January 2008

Successful Treatment of Necrobiosis Lipoidica With Antimalarial Agents

Arch Dermatol. 2008;144(1):118-119. doi:10.1001/archderm.144.1.118

Necrobiosis lipoidica (NL) is a rare granulomatous inflammatory skin disease of unknown origin, sometimes associated with diabetes mellitus (DM). The disease is often chronic, and skin lesions can progress toward ulceration and scarring. Many treatments have been proposed, but none show convincing efficacy. We describe herein the first series of patients treated with antimalarial agents for NL. Treatment brought significant improvement for 7 of 8 patients.

Eight consecutive patients presenting with NL between 1997 and 2004 were studied. All were women and middle-aged (mean age, 40.1 years). Only 1 had a history of DM. All had the skin lesions typical of NL on the anterior aspect of the legs, and 1 patient (in the context of DM) also had 1 plaque on the right forearm. A skin biopsy was performed for each patient, and the results confirmed the clinical diagnosis.