IN CLASSIC textbooks on dermatology, necrobiosis lipoidica diabeticorum is described as a cutaneous disease characterized by atrophic, yellowish, sclerotic plaques with violaceous borders occurring chiefly on the lower extremities of diabetic females. Ormsby and Montgomery 1 stated that 80% of the patients were female and 90% diabetic. The first case was described by Oppenheim 2 in 1930, and he offered the diagnostic title of dermatitis atrophicans lipoides diabetica for this condition. Urbach 3 in 1932 recognized a second case and suggested the pathogenesis of the disease. He named the lesion necrobiosis lipoidica diabeticorum (NLD). The early lesion begins as a well-defined, round, firm, glistening papule. By peripheral enlargement characteristic plaques are formed. The central portion of the lesion is yellow to yellowish brown; and as the area becomes depressed and atrophic, superficial telangiectatic blood vessels traverse the surface. Later, the border hue changes from violet to redbrown, and occasionally, the
NARVA WM, BENOIT FL, RINGROSE EJ. Necrobiosis Lipoidica Diabeticorum: With Apparently Normal Carbohydrate Tolerance. Arch Intern Med. 1965;115(6):718–722. doi:10.1001/archinte.1960.03860180090016
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