RT Book, Section
A1 Smith, Mindy A.
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164349891
T1 Necrobiosis Lipoidica
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK accessmedicine.mhmedical.com/content.aspx?aid=1164349891
RD 2024/04/18
AB A  30-year-old  woman  presents  with  discoloration  on  both  lower  legs.  She  has  no  personal  history  of  diabetes;  however,  type  2  diabetes  runs  in  her  family.  Visible  inspection  of  the  lesions  is  highly  suggestive  of  necrobiosis  lipoidica  (NL)  (Figure  231-1).  There  is  hyperpigmentation,  yellow  discoloration,  atrophy,  and  telangiectasias.  The  patient  is  not  overweight  and  had  no  symptoms  of  diabetes.  Her  blood  sugar  at  this  visit  is  142  after  eating  lunch  1  hour  prior  to  testing.  The  following  day,  the  patient's  fasting  blood  sugar  is  121,  with  a  glycosylated  hemoglobin  of  6.1.  The  patient  is  informed  of  her  borderline  diabetes,  and  diet  and  exercise  are  prescribed.  She  is  disturbed  by  her  skin  appearance  and  chooses  to  try  a  moderate-strength  topical  corticosteroid  for  treatment.