J Korean Diabetes Assoc.  2004 Oct;28(5):452-457.

A Case of Necrobiosis Lipoidica at the Insulin Injection Site in a Patient with Type 2 Diabetes Mellitus

• Kim WT
• Kim TH
• Lee SM
• Choi KH
• Ko SH
• Ahn YB
• Song KH
• Son HY
• Kim KM
• Kim SY

Abstract

Nearly one third of patients with diabetes mellitus have some kinds of dermatologic complication. Necrobiosis lipoidica (NL) is a rare degenerative disease of the collagen in the dermis occurring in 0.3~0.7% of the diabetic population. This is a dermatologic condition presenting plaques that have an erythematous, violaceous border and yellowish atrophic center with telangiectasis on its surface. One third of these lesions may progress to ulcer if exposed to any trauma. There is some controversy regarding the degree of association between NL and diabetes mellitus. Necrobiosis lipoidica is commonly seen in patients with type 1 diabetes, but 7~30% of diabetic patients with NL have type 2 diabetes. We report a case of 54 year-old woman with 25 years of diabetic history. Her skin lesion was oval or irregular indurated plaques with central atrophy occurring both arm, lower abdomen and both anterior thigh, especially at insulin injecton site. We focused glycemic control as a treatment and used antiplatelet agents such as aspirin and cilostazol on the basis of microangiopathic athophysiology, combined with antibiotics. We need to inspect more closely any of skin lesions in diabetic patients, thus misdiagnosis and improper treatment should be reduced.

Keyword

Necrobiosis lipoidica

MeSH Terms

Abdomen
Anti-Bacterial Agents
Arm
Aspirin
Atrophy
Collagen
Dermis
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Diagnostic Errors
Female
Humans
Insulin*
Middle Aged
Necrobiosis Lipoidica*
Necrobiotic Disorders*
Platelet Aggregation Inhibitors
Skin
Telangiectasis
Thigh
Ulcer
Anti-Bacterial Agents
Aspirin
Collagen
Insulin
Platelet Aggregation Inhibitors