Case Reports
Necrobiosis lipoidica diabeticorum treated with chloroquine,☆☆

https://doi.org/10.1067/mjd.2002.104969Get rights and content

Abstract

Necrobiosis lipoidica diabeticorum (NLD) is an idiopathic granulomatous skin disorder. We review previously described therapies from the recent literature and report the first case of successful treatment of NLD with oral chloroquine. (J Am Acad Dermatol 2002;46:S34-6.)

Section snippets

Case report

A 46-year-old white woman, with no personal history of diabetes, but who does have several family members with type II diabetes mellitus, had a 6-year history of a persistently tender plaque on the anterior aspect of her left lower leg. This location had been the site of trauma on 2 prior occasions. She was given oral pentoxifylline 400 mg three times daily for 1 month, but she stopped treatment because of gastrointestinal distress. Subsequent therapy included a 2-month trial of clobestasol

Discussion

Although various pharmacologic agents have been used in the treatment of NLD, we could find no previous reports of the use of antimalarials in the treatment of classic NLD.

Attempted treatments have been directed at some of the presumptive underlying mechanisms of NLD: inflammatory, microangiopathic, and structural disease. Intralesional and topical corticosteroids are frequently used in the treatment of NLD.1, 3 Systemic corticosteroid treatment has also been reported in the literature to be

References (27)

  • MC Bialas et al.

    Adverse effects of corticosteroids

    Adverse Drug React Toxicol Rev

    (1998)
  • MK Pandit et al.

    Drug-induced disorders of glucose tolerance

    Ann Intern Med

    (1993)
  • S Handfield-Jones et al.

    High dose nicotinamide in the treatment of necrobiosis lipoidica

    Br J Dermatol

    (1988)
  • Cited by (0)

    This supplement is made possible through an unrestricted educational grant from Stiefel Laboratories to the American Academy of Dermatology.

    ☆☆

    Reprint requests: Jerome Shupack, MD, New York University School of Medicine, Department of Dermatology, Dermatopharmacology Unit, 560 First Ave, H-158, New York, NY 10016.

    View full text