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Brent D. Michaels, JD; Kimberly A. Mullinax, MD; Michael J. Wells, MD; Cloyce L. Stetson, MD

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Necrobiosis lipoidica (NL) is a cutaneous disorder that commonly presents bilaterally on the shins as well-circumscribed atrophic yellow-orange patches. Histologically, palisading granulomatous infiltrates oriented parallel to the epidermis are noted.¹ When associated with diabetes mellitus (DM), it is referred to as necrobiosis lipoidica diabeticorum. More atypical presentations of plaques, papules, nodules, ulcerations, crusting, scarring, hyperpigmentation, and hemorrhage have been reported.^2-3 Histologically, less common findings include cholesterol clefts, foamy macrophages, and hemosiderin deposition. Gibson et al⁴ and De la Torre et al⁵ found cholesterol clefts in 3 NL cases of 331 reviewed. Two of the 3 patients had elevated serum cholesterol levels, and all 3 had severe DM.

Report of a Case

A 32-year-old woman with DM presented with atrophic erythematous patches and plaques on the dorsal surfaces of her feet and shins. In 1995, she had been . . . [Full Text of this Article]

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