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June 1965

Necrobiosis Lipoidica Diabeticorum: With Apparently Normal Carbohydrate Tolerance

Author Affiliations


From the Dermatology and Medical Services, US Naval Hospital, Oakland, Calif. Present address: Dermatology Service, US Naval Hospital, San Diego, Calif., and formerly, Dermatology Service, US Naval Hospital, Oakland, Calif (Lt Cdr Narva); present address: Head, Experimental Medicine Division US Naval Medical Research Institute, National Naval Medical Center, Bethesda, Md, and formerly, Medical Service, US Naval Hospital, Oakland, Calif (Lt Cdr Benoit); Consultant in Dermatology to US Naval Hospital, Oakland, Calif (Dr. Ringrose).

Arch Intern Med. 1965;115(6):718-722. doi:10.1001/archinte.1960.03860180090016

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