Type your tag names separated by a space and hit enter

Necrobiosis Lipoidica

Necrobiosis Lipoidica is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or purchase a subscription.

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

Medicine Central

-- The first section of this topic is shown below --



  • Necrobiosis lipoidica (NL) is a granulomatous skin disease.
  • Presents with violaceous red–brown skin plaques with palpable borders and yellow–brown atrophic centers with telangiectasias
  • Most commonly occurs on the pretibial area
  • Ulceration is the most common complication.
  • Ulceration found in 1/3 of cases
  • Associated with type 2 diabetes mellitus (DM) in 46% of cases.
  • May persist for decades
  • Management includes medical and/or surgical treatment.


  • 0.3–1.2% of DM patients have NL (1):
    • 11% of those with NL have DM diagnosis.
  • Female > male (3:1) (2)
  • Most prevalent in ages 20 to 40 years; may also occur in children (rare) and the elderly

Etiology and Pathophysiology

  • Exact etiology remains unknown.
  • Unclear whether a marker for diabetes severity
  • One theory suggests that NL results from systemic microangiopathy associated with DM.
  • Other theories include immunoglobulin deposition, tissue damage due to venous insufficiency and hypercholesterolemia, impaired neutrophil migration, collagen abnormalities, and trauma.
  • Pathophysiology demonstrates collagen degeneration evolving into granulomatous inflammation with dermal and subcutaneous inflammation.
  • Fatty deposition and endothelial wall thickening occur later, secondary to inflammation.

Risk Factors

  • DM
  • Hypertension
  • Obesity
  • Trauma

General Prevention

  • Smoking cessation
  • Blood glucose control
  • Avoidance of trauma
  • Compression stockings

Commonly Associated Conditions

  • Obesity, hyperlipidemia, hypertension, and diabetes complications, such as peripheral neuropathy, nephropathy, and retinopathy
  • Also may be found with thyroid disorders, sarcoid, inflammatory bowel disease, celiac disease, CHF, HLD, and rheumatoid arthritis (1)

-- To view the remaining sections of this topic, please or purchase a subscription --


Stephens, Mark B., et al., editors. "Necrobiosis Lipoidica." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816301/all/Necrobiosis_Lipoidica.
Necrobiosis Lipoidica. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816301/all/Necrobiosis_Lipoidica. Accessed April 18, 2019.
Necrobiosis Lipoidica. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816301/all/Necrobiosis_Lipoidica
Necrobiosis Lipoidica [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816301/all/Necrobiosis_Lipoidica.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Necrobiosis Lipoidica ID - 816301 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816301/all/Necrobiosis_Lipoidica PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -