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October 1960

Necrobiosis Lipoidica Granulomatosis: Necrobiosis Lipoidica Diabeticorum in the Nondiabetic

Author Affiliations

Rochester, Minn.

Fellow in Dermatology, Mayo Foundation (Dr. Rollins); Section of Dermatology (Dr. Winkelmann), Mayo Clinic and Mayo Foundation. The Mayo Foundation is a part of the Graduate School of the University of Minnesota.

Arch Dermatol. 1960;82(4):537-543. doi:10.1001/archderm.1960.01580040055010

During the past 25 years necrobiosis lipoidica diabeticorum (N.L.D.), as described by Oppenheim and Urbach and reviewed by others,1,3,6-13,16,20,24 has come to be recognized as a distinct entity. The disease is a chronic granulomatous process. Its lesions, which occur predominantly on the lower extremities, consist of irregular, sclerotic plaques with erythematous, violaceous borders and yellowish centers.

A condition described in 193614 and presented as a separate entity in 1948 by Miescher and Leder is known as Miescher's granulomatosis disciformis chronica et progressiva (Miescher's G.D.C. et P.). This is a dermatologic condition presenting discoid plaques that have an erythematous, violaceous border and a central yellowish, atrophic center with telangiectasis coursing over its surface. It is indistinguishable clinically from N.L.D., and shows some histologic similarities to it, but usually is not associated with diabetes or tuberculosis.2,5,23

We have studied in the diabetic and nondiabetic the clinical and histopathologic features

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