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Image Number 447 (Necrobiosis lipoidica)

 
Morphology:
Plaque

Diagnosis: Necrobiosis lipoidica

Site: Shins

Sex: M

Age: 40

Type: Clinical

Description: Red-brown plaque

Submitted by: Shahbaz Janjua

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Differential Diagnosis

History: Necrobiosis lipoidica (NL) was first described by Oppehhein in 1929.   NL is a disorder of unknown etiology strongly associated with diabetes mellitus but can also affect non diabetics.  It is more common in young to middle aged women but it can occur at any age It is characterised by collagen degeneration with a granulomatous response, thickening of blood vessel walls, and fat deposition.  NL typically begin as 1- to 3-mm well-circumscribed asymptomatic red-brown papules or nodules that expand with an active border to become waxy, atrophic, round plaques centrally.   Pretibial areas are the most commonly affected areas but face, scalp, upper extremities and trunk can also be involved. 

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