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A 52-year-old man with diabetes reported a 3-month history of a pretibial rash during a routine visit. He had a 15-year history of type 2 diabetes mellitus treated with insulin and a 3-year history of congestive heart failure. The lesions had begun to ulcerate and bleed but were not pruritic or painful. Physical examination showed yellow–brown plaques with ulcerations and telangiectases in the thinned epidermis. A diagnosis of necrobiosis lipoidica diabeticorum — an inflammatory skin disorder characterized by irregularly shaped, callous lesions with reddish-brown pigmentation and central atrophy — was made on the basis of visual inspection. In necrobiosis lipoidica . . . [Full Text of this Article] |
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