Erfurt-Berge C, Arnet L (2023)
Publication Type: Journal article
Publication year: 2023
Book Volume: 67
Pages Range: 90-100
Journal Issue: 1
Necrobiosis lipoidica (NL) is a granulomatous inflammatory skin disease with characteristic yellow-brown, central atrophic plaques, which usually occur pretibially on both lower legs. The diagnosis is often made based on the typical clinical presentation. In case of equivocal findings, a biopsy can rule out differential diagnoses. Because it is a rare disease and the pathogenesis is still poorly understood, there are currently no guidelines for the targeted, standard treatment of NL patients. Typically, NL usually develops in middle age and affects women more frequently. In addition, NL is often observed in combination with endocrine disorders such as diabetes mellitus or thyroid dysfunction. Also discussed is an association with metabolic syndrome, which may additionally favor the development of ulcerations and thus complicate the course of the disease. Various topical and systemic therapeutic options are available, occasionally in combination. The use of topical corticosteroids is recommended by experts generally. Some patients may benefit from topical calcineurin inhibitors, compression therapy, or phototherapy. In case of recalcitrant or ulcerated lesions, systemic therapy is often initiated. In this regard, systemic corticosteroids are used as the primary option. However, off-label therapies such as fumaric acid esters, dapsone, biologics, or JAK inhibitors have also shown promising effects in some case reports. However, due to the lack of randomized trials with large patient collectives, the efficacy of individual therapeutic options cannot be conclusively evaluated.
APA:
Erfurt-Berge, C., & Arnet, L. (2023). Therapeutische Optionen der Necrobiosis lipoidica. Internistische Praxis, 67(1), 90-100.
MLA:
Erfurt-Berge, Cornelia, and Lisa Arnet. "Therapeutische Optionen der Necrobiosis lipoidica." Internistische Praxis 67.1 (2023): 90-100.
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