Necrobiosis lipodica diabeticorum as a sign of diabetes

ABSTRACT

Necrobiosis lipoidica [NL] is a rare chronic disease. The exact cause is unknown, however, different theories suggest that it is due to a vascular disturbance involving immune complex deposition or microangiopathic changes resulting in collagen degeneration. NL has increased prevalence in patients with diabetes and is more common in females aged 30-40 years old. All patients with NLD should undergo screening for diabetes with yearly HbA1c measurements. NLD could be the first presenting sign of diabetes. A thirty-four-year-old Bahraini female, known case of gestational diabetes on diet presented with right leg skin changes. The patient was diagnosed clinically and confirmed by punch biopsy as a case of NLD. The patient was treated with Daivobet and Daflon tablets twice a day, which resulted in noticeable improvement