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. 2022 Aug;49(8):692-700.
doi: 10.1111/cup.14238. Epub 2022 Apr 25.

Histopathologic features of necrobiosis lipoidica

Emma Johnson  1 , Meera H Patel  2 , Caitlin M Brumfiel  2 , Kevin J Severson  2 , Puneet Bhullar  2 , Blake Boudreaux  2 , Richard J Butterfield  3 , David J DiCaudo  2 , Steven A Nelson  2 , Mark R Pittelkow  2 , Aaron R Mangold  2
Affiliations

Histopathologic features of necrobiosis lipoidica

Emma Johnson et al. J Cutan Pathol. 2022 Aug.

Abstract

Background: Necrobiosis lipoidica (NL) is an uncommon granulomatous dermatosis that can occur in patients with or without associated diabetes mellitus (DM). Prior studies have attempted to determine distinctive histopathologic features of NL in patients with and without DM.

Methods: A retrospective review of 97 patients with NL was performed to determine the similar and distinctive histopathologic features in patients with DM and without DM.

Results: Of the 97 patients, 32% (n = 31) had DM. Epidermal acanthosis was seen more commonly in diabetics than nondiabetics (32.3% vs. 12.1%; p = 0.017). Naked (sarcoidal/tuberculoid) granulomas were more frequently observed in nondiabetics than diabetics (22.7% vs. 3.2%; p = 0.016). Eosinophils were more common in nondiabetics than diabetics (38.5% vs. 9.7%; p = 0.004), while neutrophilic infiltration was more common in diabetics than nondiabetics (45.2% vs. 17.5%; p = 0.004).

Conclusions: This study corroborates well-documented histopathologic features of NL and shows distinctive histopathologic features of NL among patients with DM-I, DM-II, and without DM. These results support the hypothesis that there are different underlying drivers of NL between diabetics and nondiabetics.

Keywords: diabetes mellitus; granulomatous; histopathology; necrobiosis lipoidica.

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References

REFERENCES

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    1. Severson KJ, Costello CM, Brumfiel CM, et al. Clinical and morphological features of necrobiosis lipoidica. J Am Acad Dermatol. 2021, doi:10.1016/j.jaad.2021.04.034.
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