A new atypical form of lipoid necrobiosis not associated with diabetes mellitus. Clinical case and a brief review of the literature
| Dublin Core | PKP Metadata Items | Metadata for this Document | |
| 1. | Title | Title of document | A new atypical form of lipoid necrobiosis not associated with diabetes mellitus. Clinical case and a brief review of the literature |
| 2. | Creator | Author's name, affiliation, country | Daniil I. Cheboksarov ; Pavlov First Saint Petersburg State Medical University ; Россия |
| 2. | Creator | Author's name, affiliation, country | Kristina J. Molodykh; Pavlov First Saint Petersburg State Medical University ; Россия |
| 2. | Creator | Author's name, affiliation, country | Konstantin N. Monakhov; Pavlov First Saint Petersburg State Medical University ; Россия |
| 2. | Creator | Author's name, affiliation, country | Evgeny V. Sokolovskiy; Pavlov First Saint Petersburg State Medical University ; Россия |
| 3. | Subject | Discipline(s) | |
| 3. | Subject | Keyword(s) | necrobiosis lipoidica; diabetes mellitus; case report |
| 4. | Description | Abstract | The article presents a description of a clinical case of necrobiosis lipoidica complicated by ulcera-tion in a 55-year-old woman and a brief review of the literature on the topic of modern ideas about necrobiosis lipoidica. The disease manifested itself in 2005 after traumatization of the upper third of both shins as a result of a fall. The patient did visit a dermatologist office for medical help, there was a slow progression of the disease. In 2017, as a result of visiting a dermatologist office at her place of residence, she was diagnosed with necrobiosis lipoidica. The ongoing therapy with vasodi-lators and topical steroids did not lead to significant improvement. In 2021, against the background of vaccination against COVID-19 (22.07.20201 and 12.08.2021 Gam-COVID-Vac — Sputnik V) the patient notes a sharp deterioration of the process after the injection of the second component of the vaccine there were an increased in the area of lesion, ulceration. No data for diabetes mellitus were obtained during the examination. There is a history of a multi-nodular non-toxic goiter, for which a complete resection of the left lobe of the thyroid gland was performed in 1995 and a partial resection of the right lobe of the thyroid gland in 2003. The patient has been receiving L-Thyroxine replacement therapy since 2003. A biopsy of the affected skin was per-formed. The final diagnosis: necrobiosis lipoidica erythematous-ulcerative variant was established according to the pathoanatom-ic examination of the biopsy and atypical clinical picture. As a result of the therapy, the patient was discharged from the clinic with improvement. |
| 5. | Publisher | Organizing agency, location | Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov |
| 6. | Contributor | Sponsor(s) | The preparation of the manuscript was carried out by the means of the author's team. |
| 7. | Date | (DD-MM-YYYY) | 26.02.2023 |
| 8. | Type | Status & genre | Peer-reviewed Article |
| 8. | Type | Type | Research Article |
| 9. | Format | File format | PDF (Rus), PDF (Rus), |
| 10. | Identifier | Uniform Resource Identifier | https://vestnikdv.ru/jour/article/view/1369 |
| 10. | Identifier | Digital Object Identifier (DOI) | 10.25208/vdv1369 |
| 11. | Source | Title; vol., no. (year) | Vestnik dermatologii i venerologii; Vol 99, No 1 (2023) |
| 12. | Language | English=en | ru |
| 13. | Relation | Supp. Files |
Fig. 1. The state of the process when entering the Pavlov First Saint Petersburg State Medical University in 2021. Left shin. A plaque of reddish-yellow and lilac color with scalloped edges measuring 20 × 7 cm is determined. A distinctly pronounced inflammatory rim runs along the edges of the spot (1MB) Fig. 2. The state of the process upon admission to the Pavlov First Saint Petersburg State Medical University in 2021. Right shin. The lesion is represented by a plaque of reddish-yellow and lilac color with scalloped edges measuring 21 × 9 cm, on the surface of which there are 4 ulcerative defects ranging in size from 1 to 5 cm with clear boundaries, with polycyclic outlines and festooned edges. The bottom of the ulcer is covered with fibrin, the granulations are sluggish, the discharge is moderate dirty yellow, there are hemorrhagic crusts. The inflammatory border is much less pronounced than on the left shin (967KB) Fig. 3. The status of the process for 2015. The lesions are represented by erythematous plaques with indistinct edges. Telangiectasia is clearly visible. Plaques tend to grow peripherally, however, there is a linear spread of the process from the lower edge of both plaques (1MB) Fig. 4. The status of the process for 2017. The area of lesions has increased significantly. The surface has acquired a glossy sheen, there is no hair within the lesions. The color of the foci is pink-purple. At the edges there is an inflammatory border that does not rise above the surface of healthy skin. Multiple erosions are determined, which are especially noticeable on the left shin (1MB) Fig. 5. Necrobioisis lipoidica, pathohistology. а — ×20 increase, hematoxylin-eosin; б, в — ×40 increase, hematoxylin-eosin. The epidermis is thin with small epidermal protrusions, foci of necrobiosis of collagen fibers are found in all parts of the dermis, along the periphery of which focal and perivascular lymphohistiocytic infiltrates with epithelial cells are located, giant multinucleated cells are found in some of them. Fibrous layers with granulomas are noted in subcutaneous adipose tissue (979KB) |
| 14. | Coverage | Geo-spatial location, chronological period, research sample (gender, age, etc.) | |
| 15. | Rights | Copyright and permissions |
Copyright (c) 2023 Cheboksarov D.I., Molodykh K.J., Monakhov K.N., Sokolovskiy E.V. This work is licensed under a Creative Commons Attribution 4.0 International License. |