NECROBIOSIS LIPIDICA DIABETICORUM:
is an inflammatory skin disorder charactrized by collogen degeneration combined with granulomatous rezponse occuring in pts of d.m.&also rh.arthritis.
clinicaly pt preents with slowly growing,assymptimatic,patchy papules,initially red-brown then progrees to yellow depressed,atrophic plaques which may ulcerate after trauma.occuring oftenly in pretinial area bilatrally.
the exact cause is unknown many theories exist liked.micraangiopathydeposition of immunoglobulins,c3&fibrinogenantibody mediated vasculitisabn.&defective collogen fibrilstraumainfl.&metabolic changes
diagnosis is based on the distinictive appearance of the skin lession,blood sugar meassurements rewuired,but definative diagnosis is done by skin biopsy&histological exam.
D/D *granuloma anularae xanthomas skin sarcoidosis
*neurobotic xanthogranuloma
rheumatic nodules of rh.a.(histologically)
cmplications areulceration(after trauma)
*infection *rarely sq.cells carcinoma development.