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September 1956

Necrobiosis LipoidicaA Disease of Changing Concepts

AMA Arch Derm. 1956;74(3):280-285. doi:10.1001/archderm.1956.01550090054011


Changing concepts have been the hall-mark of necrobiosis lipoidica. It was first described by Oppenheim1 under the title of dermatitis atrophicans lipoides diabetica, but most of the reported cases have been under the title of necrobiosis lipoidica diabeticorum, as the entity was named by Urbach.2 This precedent was followed by Michelson and Laymon3 and Zeisler and Caro in their early reports,4 as well as by most other American authors.

A. Necrobiosis Lipoidica and Granuloma Annulare

As early as 1934 it was suggested* that necrobiosis lipoidica and granuloma annulare might represent variants of the same disease. This concept was presented in detail by Bernstein, Ellis, and Kirby-Smith.† However, although the histologic pictures are similar and occasionally clinical differentiation may be difficult, many authorities disagree.‡

B. Clinical Aspects

In a review of the literature and a study of 8 cases of their own,

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