Necrobiosis Lipoidica Differential Diagnoses

  • Author: Cheryl J Barnes, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Feb 3, 2012
 
 

Diagnostic Considerations

The clinical appearance of necrobiosis lipoidica is distinctive, yet there are many atypical presentations, and early forms can be hard to recognize.[5] Note the following:

  • Superficial annular lesions can resemble granuloma annulare
  • Yellow annular lesions of necrobiosis lipoidica with a fatty infiltration can resemble xanthomas
  • Necrobiotic xanthogranuloma is a rare disease that can mimic necrobiosis lipoidica clinically and histologically; necrobiotic xanthogranuloma has been associated with paraproteinemia and some hematologic malignancies, which is not the case with necrobiosis lipoidica
  • The clinical and histologic appearance of sarcoidosis of the skin can be like that of necrobiosis lipoidica
  • Rheumatoid nodules also have a histologic appearance similar to that of necrobiosis lipoidica, but clinically they appear as subcutaneous nodules rather than as atrophic plaques
  • Ulcerated necrobiotic lesions also have been described in patients with rheumatoid arthritis

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Cheryl J Barnes, MD  Dermatologist, McIntosh Clinic, PC

Cheryl J Barnes, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Loretta Davis, MD  Professor, Department of Internal Medicine, Division of Dermatology, Medical College of Georgia

Loretta Davis, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

David F Butler, MD Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Gregory J Raugi, MD, PhD Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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Typical presentation of necrobiosis lipoidica on the lower pretibial legs.
Red-brown plaque with yellow atrophic center on lower leg.
 
 
 
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