Necrobiosis lipoidica diabeticorum

定义

Necrobiosis lipoidica diabeticorum is an uncommon skin condition related to 糖尿病. It results in reddish brown areas of the skin, most commonly on the lower legs.

选择的名字

Necrobiosis lipoidica; NLD; Diabetes - necrobiosis

原因

The cause of necrobiosis lipoidica diabeticorum (NLD) is unknown. It is thought to be linked to blood vessel inflammation related to 自身免疫因素. This damages proteins in the skin (collagen).

People with type 1 糖尿病 are more likely to get NLD than those with type 2 糖尿病. Women are more affected than men. Smoking increases the risk for NLD. Less than one half of one percent of those with 糖尿病 suffer from this problem.

症状

A skin lesion is an area of skin that is different from the skin around it. 与全国民主联盟, 皮肤病变开始时很紧实, 光滑的, 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 溃疡. 结节也可能形成. The area may become very itchy and painful.

NLD is different from 溃疡 that can occur on the feet or ankles in people with 糖尿病.

考试和测试

Your health care provider can examine your skin to confirm the diagnosis.

If needed, your provider may do a 打孔切片 诊断疾病. The biopsy removes a sample of tissue from the edge of the lesion.

您的提供者可能会做一个 葡萄糖耐量试验 看看你是否有糖尿病.

治疗

全国民主联盟可能很难治疗. Control of blood glucose does not improve symptoms.

治疗包括:

• 皮质类固醇霜
• 注射糖皮质激素
• Drugs that suppress the immune system
• 抗炎药
• Medicines that improve blood flow
• 高压氧疗法 may be used to increase the amount of oxygen in the blood to promote healing of 溃疡
• Phototherapy, a medical procedure in which the skin is carefully exposed to ultraviolet light
• 激光疗法

在严重情况下, 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 溃疡.

If you develop 溃疡, follow steps on how to take care of the 溃疡.

If you smoke, you will be advised to 辞职. Smoking can slow healing of the lesions.

前景(预测)

民盟是一种长期疾病. Lesions do not heal well and can recur. 溃疡很难治疗. The appearance of the skin may take a long time to become normal, even after treatment.

可能出现的并发症

NLD can rarely result in skin cancer (鳞状细胞癌).

Those with NLD are at increased risk for:

• 糖尿病性视网膜病变
• 糖尿病肾病

When to Contact a Medical Professional

Contact your provider if you have 糖尿病 and notice non-healing lesions on your body, especially on the lower part of legs.

参考文献

Fitzpatrick JE, High WA, Kyle WL. 环形和靶状病变. In: Fitzpatrick JE, High WA, Kyle WL, eds. Urgent Care 皮肤病学: Symptom-Based Diagnosis. Philadelphia, PA: Elsevier; 2018:chap 16.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. 代谢错误. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical 皮肤病学. 13日艾德. Philadelphia, PA: Elsevier; 2020:chap 26.

帕特森JW. The granulomatous reaction pattern. 见:帕特森JW编. 威登氏皮肤病理学. 5日艾德. Philadelphia, PA: Elsevier; 2021:chap 8.

Rosenbach MA, Wanat KA, Reisenauer A, White KP, Korcheva V, White CR. 非感染性肉芽肿. In: Bolognia JL, Schaffer JV, Cerroni L, eds. 皮肤病学. 第四版. Philadelphia, PA: Elsevier; 2018:chap 93.