1991 Volume 34 Issue 4 Pages 359-364
The course of Necrobiosis lipoidica diabeticorum (NLD) is characterized by its chronicity and poor response to various treatment agents. This case, which was clinically and histologically typical of NLD, was successfully treated with an 8-month course of local corticosteroid creams in combination with aspirin and dipyridamole.
A 20-year-old woman diagnosed as having IDDM (insulin-dependent diabetes mellitus) at ten years of age, was admitted to our hospital because of severe skin lesions in the pretibial areas of both legs. The skin lesion on the right leg had developed at age 14 and those on the left leg, since age 18. The patient's control of her diabetes had been poor (HbA1c 11-12 %). However, the only diabetic complication which had occured was neuropathy. Increased sensitivity of the patient's platelets to ADP, epinephrine and collagen, as well as spontaneous platelet aggregation, were observed. Biopsy of one of the skin lesions in the right pretibial area showed findings typical of NLD. The patient was treated with aspirin, 1 g, and dipyridamole, 225 mg, daily in addition to local corticosteroid creams. After 8-months of therapy, the skin lesion was noticeably lighter.
