May 2005, Volume 35 Number 5 , p 65 - 65
Outline What do the lesions look like?
How are the lesions treated?
What does my patient need to know?
Graphics Figure. Necrobiosis ...
MARY WILLIAMS, 34, who has type 1 diabetes, was admitted to your unit this morning with community-acquired pneumonia. During your assessment, you notice multiple large (4- to 6-inch [10- to 15-cm]) yellowish shiny plaques on the anterior portion of both shins. These plaques are bordered by numerous telangiectases (dilated capillaries). Her left shin is much more edematous than the right.
The shiny yellow appearance of the lesions, their location, and Ms. Williams' history of diabetes lead you to suspect necrobiosis lipoidica (NL). In patients with this condition, collagen degenerates, leading to fat deposition and inflammation and thickening of blood vessel walls. The diagnosis is confirmed by a tissue biopsy. ...