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Necrobiosis Lipoidica Granulomatosis: Necrobiosis Lipoidica Diabeticorum in the Nondiabetic

Necrobiosis Lipoidica Granulomatosis: Necrobiosis Lipoidica Diabeticorum in the Nondiabetic Abstract 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 References 1. Boldt, A.: Zur Kenntnis der Necrobiosis lipoidica ("diabeticorum") , Arch. Dermat. u. Syph. 179:74-119 ( (May) ) 1939.Crossref 2. Dorn, A.: Auf Einordnung der Granulomatosis disciformis chronica et progressiva (Miescher), thesis, Frankfurt am Main, Johann Wolfgang Goethe-Universität, der hohen medizinischen Fakultät, 1958, p. 36. 3. Ellis, F. A., and Kirby-Smith, H.: Necrobiosis Lipoidica and Granuloma Annulare: A Comparative Study , Arch. Dermat. & Syph. 45:40-59 ( (Jan.) ) 1942. 4. Fisher, I.: An Unusual Late Histologic Change Seen in the Intracutaneous Tuberculin Reaction , J. Invest. Dermat. 23:233-235 ( (Oct.) ) 1954. 5. Götz, H.: Zur Frage der Beziehungen zwischen der Granulomatosis disciformis chronica et progressiva (Miescher) und der Necrobiosis lipoidica diabeticorum , Hautarzt 7:156-161 ( (April) ) 1956. 6. Hare, P. J.: Necrobiosis Lipoidica , Brit. J. Dermat. 67:365-384 ( (Nov.) ) 1955. 7. Hildebrand, A. G.; Montgomery, H., and Rynearson, E. H.: Necrobiosis Lipoidica Diabeticorum , Arch. Int. Med. 66:851-878 ( (Oct.) ) 1940. 8. Kaalund-Jørgenson, O.: Necrobiosis Lipoidica (Diabeticorum) , Acta dermat.-venereol. 28:214-230, 1948. 9. Knoth, W., and Füller, H.: Zur Patho- und Histogenese der Nekrobiosis lipoidica "diabeticorum," Arch. Dermat. u. Syph. 199:109-133, 1955. 10. Laymon, C. W., in discussion on Michelson, H. E.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 33:900 ( (May) ) 1936. 11. Laymon, C. W., and Fisher, I.: Necrobiosis Lipoidica (Diabeticorum?): A Histologic Study and Comparison with Granuloma Annulare , Arch. Dermat. & Syph. 59:150-167 ( (Feb.) ) 1949. 12. Michelson, H. E.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 30:897-898 ( (Dec.) ) 1934. 13. Michelson, H. E., and Laymon, C. W.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 35:1130-1136 ( (June) ) 1937. 14. Miescher, G.: Die Bedeutung der Ekzemforschung für die Gewerbedermatosen , Schweiz. med. Wchnschr. 67:833-834 ( (Aug. 28) ) 1937. 15. Miescher, G., and Leder, M.: Granulomatosis disciformis chronica et progressiva (atypische Tuberkulose) , Dermatologica ( (Suppl. 97) ) pp. 25-34, 1948. 16. Mom, A. M., and Corti, R. N.: Necrobiosis Lipóidica: Estudio clínico e histopathológico y análisis de 28 casos argentinos , Prensa méd. argent. 37:2711-2718 ( (Nov. 10) ) 1950. 17. Oppenheim: Eigentümliche disseminierte Degeneration des Bindegewebes der Haut bei einem Diabetiker , Abstract, Zentralbl. Haut- u. Geschlechtskr. 32:179, 1929-1930. 18. Oppenheim, M.: Über eine bisher nicht beschriebene, mit eigentümlicher lipoider Degeneration der Elastica und des Bindegewebes einhergehende chronische Dermatose bei Diabetes mellitus (Dermatitis atrophicans lipoides diabetica) , Arch. Dermat. u. Syph. 166:576-583 ( (Oct.) ) 1932. 19. Shelley, W. B., and Hurley, H. J.: The Allergic Origin of Zirconium Deodorant Granulomas , Brit. J. Dermat. 70:75-101 ( (March) ) 1958. 20. Smith, J. G., Jr.: Necrobiosis Lipoidica: A Disease of Changing Concepts , A.M.A. Arch. Dermat. 74:280-285 ( (Sept.) ) 1956. 21. Urbach, E.: Beiträge zu einer physiologischen und pathologischen chemie der Haut: X. Mitteilung. Eine neue diabetische Stoffwechseldermatose: Nekrobiosis lipoidica diabeticorum , Arch. Dermat. u. Syph. 166:273-285 ( (Sept.) ) 1932. 22. Woringer, F.: Relations entre la granulomatose disciforme chronique et progressive et la nécrobiose lipoídique , Bull. Soc. franç. dermat. et syph. 63:394-397 ( (July 12) ) 1956. 23. Woringer, F., and Ullmo, A.: Granulomatosis disciformis chronica et progressiva Miescher , Ann. dermat. et syph. 84:22-28 ( (Jan.) -Feb.) 1957. 24. Zeisler, E. P., and Caro, M. R.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 30:796-812 ( (Dec.) ) 1934. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Necrobiosis Lipoidica Granulomatosis: Necrobiosis Lipoidica Diabeticorum in the Nondiabetic

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1960.01580040055010
Publisher site
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Abstract

Abstract 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 References 1. Boldt, A.: Zur Kenntnis der Necrobiosis lipoidica ("diabeticorum") , Arch. Dermat. u. Syph. 179:74-119 ( (May) ) 1939.Crossref 2. Dorn, A.: Auf Einordnung der Granulomatosis disciformis chronica et progressiva (Miescher), thesis, Frankfurt am Main, Johann Wolfgang Goethe-Universität, der hohen medizinischen Fakultät, 1958, p. 36. 3. Ellis, F. A., and Kirby-Smith, H.: Necrobiosis Lipoidica and Granuloma Annulare: A Comparative Study , Arch. Dermat. & Syph. 45:40-59 ( (Jan.) ) 1942. 4. Fisher, I.: An Unusual Late Histologic Change Seen in the Intracutaneous Tuberculin Reaction , J. Invest. Dermat. 23:233-235 ( (Oct.) ) 1954. 5. Götz, H.: Zur Frage der Beziehungen zwischen der Granulomatosis disciformis chronica et progressiva (Miescher) und der Necrobiosis lipoidica diabeticorum , Hautarzt 7:156-161 ( (April) ) 1956. 6. Hare, P. J.: Necrobiosis Lipoidica , Brit. J. Dermat. 67:365-384 ( (Nov.) ) 1955. 7. Hildebrand, A. G.; Montgomery, H., and Rynearson, E. H.: Necrobiosis Lipoidica Diabeticorum , Arch. Int. Med. 66:851-878 ( (Oct.) ) 1940. 8. Kaalund-Jørgenson, O.: Necrobiosis Lipoidica (Diabeticorum) , Acta dermat.-venereol. 28:214-230, 1948. 9. Knoth, W., and Füller, H.: Zur Patho- und Histogenese der Nekrobiosis lipoidica "diabeticorum," Arch. Dermat. u. Syph. 199:109-133, 1955. 10. Laymon, C. W., in discussion on Michelson, H. E.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 33:900 ( (May) ) 1936. 11. Laymon, C. W., and Fisher, I.: Necrobiosis Lipoidica (Diabeticorum?): A Histologic Study and Comparison with Granuloma Annulare , Arch. Dermat. & Syph. 59:150-167 ( (Feb.) ) 1949. 12. Michelson, H. E.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 30:897-898 ( (Dec.) ) 1934. 13. Michelson, H. E., and Laymon, C. W.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 35:1130-1136 ( (June) ) 1937. 14. Miescher, G.: Die Bedeutung der Ekzemforschung für die Gewerbedermatosen , Schweiz. med. Wchnschr. 67:833-834 ( (Aug. 28) ) 1937. 15. Miescher, G., and Leder, M.: Granulomatosis disciformis chronica et progressiva (atypische Tuberkulose) , Dermatologica ( (Suppl. 97) ) pp. 25-34, 1948. 16. Mom, A. M., and Corti, R. N.: Necrobiosis Lipóidica: Estudio clínico e histopathológico y análisis de 28 casos argentinos , Prensa méd. argent. 37:2711-2718 ( (Nov. 10) ) 1950. 17. Oppenheim: Eigentümliche disseminierte Degeneration des Bindegewebes der Haut bei einem Diabetiker , Abstract, Zentralbl. Haut- u. Geschlechtskr. 32:179, 1929-1930. 18. Oppenheim, M.: Über eine bisher nicht beschriebene, mit eigentümlicher lipoider Degeneration der Elastica und des Bindegewebes einhergehende chronische Dermatose bei Diabetes mellitus (Dermatitis atrophicans lipoides diabetica) , Arch. Dermat. u. Syph. 166:576-583 ( (Oct.) ) 1932. 19. Shelley, W. B., and Hurley, H. J.: The Allergic Origin of Zirconium Deodorant Granulomas , Brit. J. Dermat. 70:75-101 ( (March) ) 1958. 20. Smith, J. G., Jr.: Necrobiosis Lipoidica: A Disease of Changing Concepts , A.M.A. Arch. Dermat. 74:280-285 ( (Sept.) ) 1956. 21. Urbach, E.: Beiträge zu einer physiologischen und pathologischen chemie der Haut: X. Mitteilung. Eine neue diabetische Stoffwechseldermatose: Nekrobiosis lipoidica diabeticorum , Arch. Dermat. u. Syph. 166:273-285 ( (Sept.) ) 1932. 22. Woringer, F.: Relations entre la granulomatose disciforme chronique et progressive et la nécrobiose lipoídique , Bull. Soc. franç. dermat. et syph. 63:394-397 ( (July 12) ) 1956. 23. Woringer, F., and Ullmo, A.: Granulomatosis disciformis chronica et progressiva Miescher , Ann. dermat. et syph. 84:22-28 ( (Jan.) -Feb.) 1957. 24. Zeisler, E. P., and Caro, M. R.: Necrobiosis Lipoidica Diabeticorum , Arch. Dermat. & Syph. 30:796-812 ( (Dec.) ) 1934.

Journal

Archives of DermatologyAmerican Medical Association

Published: Oct 1, 1960

References