Necrobiosis lipoidica
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Necrobiosis lipoidica | |
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Diagnosis in short | |
Necrobiosis lipoidica. HPS stain. | |
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LM | (dermal) palisading granulomas around necrotic collagen; little mucin; no normal dermis between foci; plasma cells - common; +/-involvement of subcutis |
LM DDx | granuloma annulare, rheumatoid nodule |
Site | skin |
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Associated Dx | diabetes mellitus, rheumatoid arthritis |
Prevalence | uncommon |
Necrobiosis lipoidica is an uncommon granulomatous skin pathology.
General
Associated with:
- Diabetes mellitus - known as necrobiosis lipoidica diabeticorum.
- Rheumatoid arthritis.
Gross
Image:
Microscopic
Features:[1]
- Dermal palisading granuloma around:
- Necrotic collagen - key feature.
- Nuclei "missing" - have undergone karyolysis.
- Necrotic collagen - key feature.
- Little mucin, no normal dermis between foci.
- Plasma cells - common.[2]
- May involve adipose tissue.
DDx:
- Granuloma annulare - more mucin, normal dermis between foci,[1] plasma cells uncommon,[2] no fat involvement - usu. more superficial.
- Rheumatoid nodule.
Images
www:
- Necrobiosis lipoidica (dermatology.cdlib.org).
- Necrobiosis lipoidica (drmihm.com).
- Necrobiosis lipoidica (dermnetnz.org).
See also
References
- ↑ 1.0 1.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 51. ISBN 978-0443066542.
- ↑ 2.0 2.1 URL: http://dermnetnz.org/pathology/necrobiosis-lipoidica-path.html. Accessed on: 24 January 2012.