Necrobiosis lipoidica is an inflammatory disorder, associated with diabetes mellitus, for which the underlying pathological mechanism is unknown and for which there is no rational therapy. However, benefit has been reported from such different treatment regimens as drugs acting on the haemostatic mechanisms, corticosteroid therapy (topical, intralesional and systemic), enhancers of wound healing, surgery and immunomodulating therapies (including photochemotherapy). This is a review of these treatment options.
Santos-Juanes J., Galache C., Curto JR et al. Squamous cell carcinoma arising in long-standing necrobiosis lipoidica. J Eur Acad Dermatol Venereol2004;18:199-200.
9.
Holland C., Givens V., Smoller BRExpression of the human erythrocyte glucose transporter Glut-1 in areas of sclerotic collagen in necrobiosis lipoidica. J Cutan Pathol2001;28:287-90.
10.
Boateng B., Hiller D., Albrecht HP, Hornstein OPCutaneous microcirculation in pretibial necrobiosis lipoidica. Comparative laser Doppler flowmetry and oxygen partial pressure determinations in patients and healthy probands. Hautarzt1993;44:581-6.
11.
Alegre VA, Winkelmann RKA new histopathologic feature of necrobiosis lipoidica diabeticorum: lymphoid nodules. J Cutan Pathol1988;15: 75-7.
12.
Statham B., Finlay AY, Marks R.A randomised double blind comparison of an aspirin dipyridamole combination versus a placebo in the treatment of necrobiosis lipoidica. Acta Derm Venereol1981;61:270-1.
13.
Karkavitsas K., Miller JA, Dowd PM, Kirby JDAspirin in the management of necrobiosis lipoidica . Acta Derm Venereol1982;62:183.
14.
Beck H.-I, Bjerring P., Rasmussen I. et al. Treatment of necrobiosis lipoidica with low-dose acetylsalicylic acid. A randomised double-blind trial. Acta Derm Venereol1985;65:230-4.
15.
Heng MCY , Song MK, Heng MKHealing of necrobiotic ulcers with antiplatelet therapy. Correlation with plasma thromboxane levels. Int J Dermatol1989;28:195-7.
16.
Rhodes ELNecrobiosis lipoidica treated with ticlopidine. Acta Derm Venereol1986;66:458.
17.
Bonnetblanc JM, Julia A., Rigaud M.Antithrombotic agents in necrobiosis lipoidica . Acta Derm Venereol1986;66:90.
18.
Rhodes ELFibrinolytic agents in the treatment of necrobiosis lipoidica. Br J Dermatol1976;95:673-4.
19.
Littler CM, Tschen EHPentoxifylline for necrobiosis lipoidica diabeticorum. J Am Acad Dermatol1987;17:314-16.
Espana A., Sanchez-Yus E., Serna MJ et al. Chronic balanitis with palisading granuloma: an atypical genital localization of necrobiosis lipoidica responsive to pentoxifylline. Dermatology1994;188:222-5.
Kuwert C., Abeck D., Steinkraus V. et al. Prostaglandin E1 improves necrobiosis lipoidica. Acta Derm Venereol1995;75:319-20.
24.
Wilkin JKPerilesional heparin injections for necrobiosis lipoidica. J Am Acad Dermatol1983;8:904.
25.
Sparrow G., Abell E.Granuloma annulare and necrobiosis lipoidica treated by jet injector . Br J Dermatol1975;93:85-9.
26.
Goette DKResolution of necrobiosis lipoidica with exclusive clobetasol propionate treatment . J Am Acad Dermatol1990;22:855-6.
27.
Volden G.Successful treatment of chronic skin diseases with clobetasol propionate and a hydrocolloid occlusive dressing. Acta Derm Venereol1992;72:69-71.
28.
Petzelbauer P., Wolff K., Tappeiner G.Necrobiosis lipoidica: treatment with systemic corticosteroids. Br J Dermatol1992;126:542-5.
29.
Taniguchi Y. , Sakamoto T., Shimizu M.A case of necrobiosis lipoidica treated with systemic corticosteroid. J Dermatol1993;20:304-07.
30.
Youshock E. , Beninson J.Necrobiosis lipoidica: treatment with porcine dressings, split thickness skin grafts and pressure garments. A case report and review of treatment modalities. Angiology1985;36:821-6.
31.
Sawada Y.Successful treatment of ulcerated necrobiosis lipoidica diabeticorum with prostaglandin E1 and skin flap transfer - a case report. J Dermatol1985;12:449-54.
32.
Marr TJ, Traisman HS, Griffith BH, Schafer MANecrobiosis lipoidica diabeticorum in a juvenile diabetic: treatment by excision and skin grafting. Cutis1977;19:348-50.
Gebauer K., Armstrong M.Koebner phenomenon with necrobiosis lipoidica diabeticorum. Int J Dermatol1993;32:895-6.
36.
Vion B., Burri G., Ramelet AANecrobiosis lipoidica and silicotic granulomas on Muller's phlebectomy scars . Dermatology1997;194:55-8.
37.
Ghate JV, Williford PM, Sane DC, Hitchcock MGNecrobiosis lipoidica associated with Kobner's phenomenon in a patient with diabetes. Cutis2001;67:158-60.
38.
Moreno-Arias GA, Camps-Fresneda A.Necrobiosis lipoidica diabeticorum treated with the pulsed dye laser. J Cosmet Laser Ther2001;3:143-6.
39.
Currie CL, Monk BEPulsed dye laser treatment of necrobiosis lipoidica: report of a case. J Cutan Laser Ther1999;1:239-41.
40.
Remes K., Ronnemaa T.Healing of chronic leg ulcers in diabetic necrobiosis lipoidica with local granulocyte-macrophage colony stimulating factor treatment. J Diabetes Complications1999;13:115-18.
41.
Evans AV, Atherton DJRecalcitrant ulcers in necrobiosis lipoidica diabeticorum healed by topical granulocyte-macrophage colony-stimulating factor. Br J Dermatol2002;147:1023-5.
42.
Stephens E., Robinson JA, Gottlieb PABecaplermin and necrobiosis lipoidicum diabeticorum: results of a case control pilot study. J Diabetes Complications2001 ;15:55-6.
43.
Omugha N., Jones AMThe management of hard-to-heal necrobiosis with Promogran. Br J Nurs2003;12:S14-S20.
44.
Owen CM, Murphy H., Yates VMTissue-engineered dermal skin grafting in the treatment of ulcerated necrobiosis lipoidica. Clin Exp Dermatol2001 ;26:176-8.
45.
Stuart L., Wiles PGManagement of ulcerated necrobiosis lipoidica: an innovative approach . Br J Dermatol2001;144:907-09.
46.
Spenceri EA, Nahass GTTopically applied bovine collagen in the treatment of ulcerative necrobiosis lipoidica diabeticorum. Arch Dermatol1997 ;133:817-19.
47.
Weisz G., Ramon Y., Waisman D., Melamed Y.Treatment of necrobiosis lipoidica diabeticorum by hyperbaric oxygen . Acta Derm Venereol1993; 73:447-8.
48.
Bouhanick B. , Verret JL, Gouello JP et al. Necrobiosis lipoidica: treatment by hyperbaric oxygen and local corticosteroids. Diabetes Metab1998; 24:156-9.
49.
Smith K.Ulcerating necrobiosis lipoidica resolving in response to cyclosporine - A . Dermatol Online J1997;3:2.
50.
Darvay A., Acland KM, Russell-Jones R.Persistent ulcerated necrobiosis lipoidica responding to treatment with cyclosporin . Br J Dermatol1999; 141:725-7.
51.
Stinco G., Parlangeli ME, De Francesco V. et al. Ulcerated necrobiosis lipoidica treated with cyclosporin A. Acta Derm Venereol2003;83:151-3.
52.
Stanway A., Rademaker M., Newman P.Healing of severe ulcerative necrobiosis lipoidica with cyclosporin . Australas J Dermatol2004;45: 119-22.
53.
Reinhard G. , Lohmann F., Uerlich M. et al. Successful treatment of ulcerated necrobiosis lipoidica with mycophenolate mofetil. Acta Derm Venereol2000;80:312-13.
54.
Kolde G., Muche JM, Schulze P. et al. Infliximab: a promising new treatment option for ulcerated necrobiosis lipoidica. Dermatology2003;206: 180-1.
55.
Drosou A., Kirsner RS, Welsh E. et al. Use of infliximab, an anti-tumor necrosis alpha antibody, for inflammatory dermatoses. J Cutan Med Surg2003;7:382-6.
56.
Gambichler T., Kreuter A., Freitag M. et al. Clearance of necrobiosis lipoidica with Fumaric Acid Esters. Dermatology2003 ;207:422-4.
57.
Harth W., Linse R.Topical tacrolimus in granuloma annulare and necrobiosis lipoidica . Br J Dermatol2004;150:792-4.
58.
Patel GK, Rashid A., Mills CMTopical photochemotherapy: a ray of hope for the treatment of necrobiosis lipoidica. Br J Dermatol1999;141(suppl 55):118.
59.
Ling TC, Thomson KF, Goulden V., Goodfield MJPUVA therapy in necrobiosis lipoidica diabeticorum. J Am Acad Dermatol2002;46:319-20.
60.
McKenna DB, Cooper EJ, Tidman MJTopical psoralen plus ultraviolet A treatment for necrobiosis lipoidica . Br J Dermatol2000;143:1333-5.
61.
De Rie MA, Sommer A., Hoekzema R., Neumann HATreatment of necrobiosis lipoidica with topical psoralen plus ultraviolet A. Br J Dermatol2002;147:743-7.
Handfield - Jones S., Jones S., Peachey R.High dose nicotinamide in the treatment of necrobiosis lipoidica. Br J Dermatol1988;118:693-6.
64.
Mensing H.Clofazimine - therapeutic alternative in necrobiosis lipoidica and granuloma annulare. Hautarzt1989;40:99-103.
65.
Heymann WRNecrobiosis lipoidica treated with topical tretinoin. Cutis1996;58:53-4.
66.
Boyd ASTretinoin treatment of necrobiosis lipoidica diabeticorum. Diabetes Care1999;22:1753-4.
67.
Hanke CW, Bergfeld WFTreatment with benzoyl peroxide of ulcers on legs within lesions of necrobiosis lipoidica diabeticorum. J Dermatol Surg Oncol1978;4:701-04.
68.
Nguyen K., Washenik K., Shupack J.Necrobiosis lipoidica diabeticorum treated with chloroquine. J Am Acad Dermatol2002;46:S34-S36.