Perforating Necrobiosis Lipoidica



Pirouzi S¹ ; Zargari O² ; Kamyab K³ ; Kesty K⁴
Source: Iranian Journal of Dermatology Published:2017

Abstract

Perforating necrobiosis lipoidica (PNL) is a very rare variant of necrobiosis lipoidica (NL), almost always associated with diabetes. A non-diabetic 43-year-old man referred to us with a gradually enlarging plaque on his forehead. The patient was initially diagnosed with cutaneous tuberculosis based on the histopathologic findings, but failed to respond to anti-tuberculosis therapy. Upon further evaluation and observation of the transepidermal elimination of degenerated collagen in the pathology slides, we rendered a diagnosis of PNL. The patient underwent successful treatment with topical tacrolimus and systemic hydroxychloroquine. © 2017 Iranian Society of Dermatology.