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June 1959

Smoking, Necrobiosis Lipoidica, Granulomatosis Disciformis Chronica Progressiva

AMA Arch Derm. 1959;79(6):635-640. doi:10.1001/archderm.1959.01560180009003

Smoking by constitutionally predisposed persons causes necrobiosis lipoidica "diabeticorum" in nondiabetics, causes the apparently identical granulomatosis disciformis chronica progressiva, and aggravates necrobiosis lipoidica diabeticorum in diabetics—this hypothesis may be important in clarifying the etiology of necrobiosis lipoidica and granulomatosis disciformis chronica progressiva.

The condition recognized by most dermatologists as necrobiosis lipoidica diabeticorum was first described by Oppenheim,1 in 1929, as dermatitis atrophicans lipoides diabetica. Urbach,2 in 1932, gave it the name by which we now call it, but, ever since Goldsmith,3 in 1934, recorded a case without diabetes, more and more nondiabetic patients have been seen with this condition. Thus, Hildebrand, Montgomery, and Rynearson,4 in 1940, found approximately 10% of their cases, and those reported in the literature prior to that time, were nondiabetics. Kaalund-Jørgensen,5 in 1948, found approximately one-third of his cases and the cases reported

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