Necrobiosis lipoidica, a disease of changing concepts.

Abstract

Introduction Changing concepts have been the hall-mark of necrobiosis lipoidica. It was first described by Oppenheim¹under the title of dermatitis atrophicans lipoides diabetica, but most of the reported cases have been under the title of necrobiosis lipoidica diabeticorum, as the entity was named by Urbach.²This precedent was followed by Michelson and Laymon³and Zeisler and Caro in their early reports,⁴as well as by most other American authors. A. Necrobiosis Lipoidica and Granuloma Annulare As early as 1934 it was suggested^*that necrobiosis lipoidica and granuloma annulare might represent variants of the same disease. This concept was presented in detail by Bernstein, Ellis, and Kirby-Smith.† However, although the histologic pictures are similar and occasionally clinical differentiation may be difficult, many authorities disagree.‡ B. Clinical Aspects In a review of the literature and a study of 8 cases of their own,