Necrobiosis Lipoidica Differential Diagnoses

Updated: Jan 12, 2022
  • Author: Cheryl J Barnes, MD; Chief Editor: George T Griffing, MD  more...
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Diagnostic Considerations

The clinical appearance of necrobiosis lipoidica is distinctive, yet there are many atypical presentations, and early forms can be hard to recognize. [13] 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