BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuNecrobiosis lipoidica diabeticorumNecrobiosis lipoidica; NLD; Diabetes - necrobiosisNecrobiosis lipoidica diabeticorum is an uncommon skin condition related to diabetes. It results in reddish brown areas of the skin, most commonly on the lower legs.DiabetesDiabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.ImageRead Article Now Book Mark Article Causes The cause of necrobiosis lipoidica diabeticorum (NLD) is unknown. It is thought to be linked to blood vessel inflammation related to autoimmune factors. This damages proteins in the skin (collagen).Autoimmune factorsAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article People with type 1 diabetes are more likely to get NLD than those with type 2 diabetes. Women are more affected than men. Smoking increases the risk for NLD. Less than one half of one percent of those with diabetes suffer from this problem. Symptoms A skin lesion is an area of skin that is different from the skin around it. With NLD, skin lesions start as firm, smooth, red bumps (papules) on the shins and lower part of the legs. They usually appear in the same areas on opposite sides of the body. They are painless in the early stage.As the papules become bigger, they flatten. They develop a shiny yellow brown center with raised red to purplish edges. Veins are visible below the yellow part of the lesions. The lesions are irregularly round or oval with well-defined borders. They can spread and join together to give the appearance of a patch.Lesions can also occur on the forearms. Rarely, they may occur on the stomach, face, scalp, palms, and soles of the feet.Trauma may cause the lesions to develop ulcers. Nodules also may develop. The area may become very itchy and painful.UlcersIf you have diabetes, you have an increased chance of developing foot sores, or ulcers, also called diabetic ulcers. Foot ulcers are a common reason ...Read Article Now Book Mark Article NLD is different from ulcers that can occur on the feet or ankles in people with diabetes. Exams and Tests Your health care provider can examine your skin to confirm the diagnosis.If needed, your provider may do a punch biopsy to diagnose the disease. The biopsy removes a sample of tissue from the edge of the lesion.Punch biopsyA skin lesion biopsy is when a small amount of skin is removed so it can be examined under a microscope. The skin is tested to look for skin conditi...ImageRead Article Now Book Mark Article Your provider may do a glucose tolerance test to see if you have diabetes.Glucose tolerance testThe glucose tolerance test is a lab test to check how your body moves sugar from the blood into tissues like muscle and fat. The test is often used ...ImageRead Article Now Book Mark Article Treatment NLD can be difficult to treat. Control of blood glucose does not improve symptoms.Treatment may include:Corticosteroid creams Injected corticosteroids Drugs that suppress the immune system Anti-inflammatory drugs Medicines that improve blood flow Hyperbaric oxygen therapy may be used to increase the amount of oxygen in the blood to promote healing of ulcers Hyperbaric oxygen therapyHyperbaric oxygen therapy uses a special pressure chamber to increase the amount of oxygen in the blood.Read Article Now Book Mark Article Phototherapy, a medical procedure in which the skin is carefully exposed to ultraviolet light Laser therapyIn severe cases, the lesion may be removed by surgery, followed by moving (grafting) skin from other parts of body to the operated area.During treatment, monitor your glucose level as instructed. Avoid injury to the area to prevent the lesions from turning into ulcers.If you develop ulcers, follow steps on how to take care of the ulcers.If you smoke, you will be advised to quit. Smoking can slow healing of the lesions.QuitThere are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...ImageRead Article Now Book Mark Article Outlook (Prognosis) NLD is a long-term disease. Lesions do not heal well and can recur. Ulcers are difficult to treat. The appearance of the skin may take a long time to become normal, even after treatment. Possible Complications NLD can rarely result in skin cancer (squamous cell carcinoma).Squamous cell carcinomaSquamous cell skin cancer is the second most common type of cancer in the United States. Other common types of skin cancer are:Basal cell cancerMelan...ImageRead Article Now Book Mark Article Those with NLD are at increased risk for:Diabetic retinopathy Diabetic retinopathyDiabetes can harm the eyes. It can damage the small blood vessels in the retina, the back part of your eye. This condition is called diabetic retin...ImageRead Article Now Book Mark Article Diabetic nephropathyDiabetic nephropathyKidney disease or kidney damage often occurs over time in people with diabetes. This type of kidney disease is called diabetic nephropathy.ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you have diabetes and notice non-healing lesions on your body, especially on the lower part of legs.Open ReferencesReferencesFitzpatrick JE, High WA, Kyle WL. Annular and targetoid lesions. In: Fitzpatrick JE, High WA, Kyle WL, eds. Urgent Care Dermatology: Symptom-Based Diagnosis. Philadelphia, PA: Elsevier; 2018:chap 16.James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Errors in metabolism. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 26.Patterson JW. The granulomatous reaction pattern. In: Patterson JW, ed. Weedon's Skin Pathology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 8.Rosenbach MA, Wanat KA, Reisenauer A, White KP, Korcheva V, White CR. Non-infectious granulomas. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 93.AllVideoImagesTogNecrobiosis lipoidica diabeticorum - abdomen - illustration Necrobiosis lipoidica diabeticorum is a chronic skin disease characterized by shiny plaques that vary in color from light yellowish to reddish-tan. It is seen more commonly in women. Although the name implies diabetes and the majority of cases occur in diabetics, this condition can occur in individuals without diabetes.Necrobiosis lipoidica diabeticorum - abdomenillustrationNecrobiosis lipoidica diabeticorum - leg - illustration Necrobiosis lipoidica diabeticorum is a chronic skin disease characterized by shiny plaques that vary in color from light yellowish to reddish-tan. It is seen more commonly in women. Although the name implies diabetes and the majority of cases occur in diabetics, this condition can occur in individuals without diabetes.Necrobiosis lipoidica diabeticorum - legillustrationNecrobiosis lipoidica diabeticorum - abdomen - illustration Necrobiosis lipoidica diabeticorum is a chronic skin disease characterized by shiny plaques that vary in color from light yellowish to reddish-tan. It is seen more commonly in women. Although the name implies diabetes and the majority of cases occur in diabetics, this condition can occur in individuals without diabetes.Necrobiosis lipoidica diabeticorum - abdomenillustrationNecrobiosis lipoidica diabeticorum - leg - illustration Necrobiosis lipoidica diabeticorum is a chronic skin disease characterized by shiny plaques that vary in color from light yellowish to reddish-tan. It is seen more commonly in women. Although the name implies diabetes and the majority of cases occur in diabetics, this condition can occur in individuals without diabetes.Necrobiosis lipoidica diabeticorum - legillustrationRelated Information Review Date: 8/12/2022 Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. 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Necrobiosis lipoidica diabeticorumNecrobiosis lipoidica; NLD; Diabetes - necrobiosisNecrobiosis lipoidica diabeticorum is an uncommon skin condition related to diabetes. It results in reddish brown areas of the skin, most commonly on the lower legs.DiabetesDiabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.ImageRead Article Now Book Mark Article Causes The cause of necrobiosis lipoidica diabeticorum (NLD) is unknown. It is thought to be linked to blood vessel inflammation related to autoimmune factors. This damages proteins in the skin (collagen).Autoimmune factorsAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article People with type 1 diabetes are more likely to get NLD than those with type 2 diabetes. Women are more affected than men. Smoking increases the risk for NLD. Less than one half of one percent of those with diabetes suffer from this problem. Symptoms A skin lesion is an area of skin that is different from the skin around it. With NLD, skin lesions start as firm, smooth, red bumps (papules) on the shins and lower part of the legs. They usually appear in the same areas on opposite sides of the body. They are painless in the early stage.As the papules become bigger, they flatten. They develop a shiny yellow brown center with raised red to purplish edges. Veins are visible below the yellow part of the lesions. The lesions are irregularly round or oval with well-defined borders. They can spread and join together to give the appearance of a patch.Lesions can also occur on the forearms. Rarely, they may occur on the stomach, face, scalp, palms, and soles of the feet.Trauma may cause the lesions to develop ulcers. Nodules also may develop. The area may become very itchy and painful.UlcersIf you have diabetes, you have an increased chance of developing foot sores, or ulcers, also called diabetic ulcers. Foot ulcers are a common reason ...Read Article Now Book Mark Article NLD is different from ulcers that can occur on the feet or ankles in people with diabetes. Exams and Tests Your health care provider can examine your skin to confirm the diagnosis.If needed, your provider may do a punch biopsy to diagnose the disease. The biopsy removes a sample of tissue from the edge of the lesion.Punch biopsyA skin lesion biopsy is when a small amount of skin is removed so it can be examined under a microscope. The skin is tested to look for skin conditi...ImageRead Article Now Book Mark Article Your provider may do a glucose tolerance test to see if you have diabetes.Glucose tolerance testThe glucose tolerance test is a lab test to check how your body moves sugar from the blood into tissues like muscle and fat. The test is often used ...ImageRead Article Now Book Mark Article Treatment NLD can be difficult to treat. Control of blood glucose does not improve symptoms.Treatment may include:Corticosteroid creams Injected corticosteroids Drugs that suppress the immune system Anti-inflammatory drugs Medicines that improve blood flow Hyperbaric oxygen therapy may be used to increase the amount of oxygen in the blood to promote healing of ulcers Hyperbaric oxygen therapyHyperbaric oxygen therapy uses a special pressure chamber to increase the amount of oxygen in the blood.Read Article Now Book Mark Article Phototherapy, a medical procedure in which the skin is carefully exposed to ultraviolet light Laser therapyIn severe cases, the lesion may be removed by surgery, followed by moving (grafting) skin from other parts of body to the operated area.During treatment, monitor your glucose level as instructed. Avoid injury to the area to prevent the lesions from turning into ulcers.If you develop ulcers, follow steps on how to take care of the ulcers.If you smoke, you will be advised to quit. Smoking can slow healing of the lesions.QuitThere are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...ImageRead Article Now Book Mark Article Outlook (Prognosis) NLD is a long-term disease. Lesions do not heal well and can recur. Ulcers are difficult to treat. The appearance of the skin may take a long time to become normal, even after treatment. Possible Complications NLD can rarely result in skin cancer (squamous cell carcinoma).Squamous cell carcinomaSquamous cell skin cancer is the second most common type of cancer in the United States. Other common types of skin cancer are:Basal cell cancerMelan...ImageRead Article Now Book Mark Article Those with NLD are at increased risk for:Diabetic retinopathy Diabetic retinopathyDiabetes can harm the eyes. It can damage the small blood vessels in the retina, the back part of your eye. This condition is called diabetic retin...ImageRead Article Now Book Mark Article Diabetic nephropathyDiabetic nephropathyKidney disease or kidney damage often occurs over time in people with diabetes. This type of kidney disease is called diabetic nephropathy.ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you have diabetes and notice non-healing lesions on your body, especially on the lower part of legs.Open ReferencesReferencesFitzpatrick JE, High WA, Kyle WL. Annular and targetoid lesions. In: Fitzpatrick JE, High WA, Kyle WL, eds. Urgent Care Dermatology: Symptom-Based Diagnosis. Philadelphia, PA: Elsevier; 2018:chap 16.James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Errors in metabolism. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 26.Patterson JW. The granulomatous reaction pattern. In: Patterson JW, ed. Weedon's Skin Pathology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 8.Rosenbach MA, Wanat KA, Reisenauer A, White KP, Korcheva V, White CR. Non-infectious granulomas. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 93.