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Perforating Necrobiosis Lipoidica



Pirouzi S1 ; Zargari O2 ; Kamyab K3 ; Kesty K4
Authors
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Authors Affiliations
  1. 1. Department of Dermatology, Azad University, Tehran, Iran
  2. 2. Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Wake Forest University School of Medicine, Winston-Salem, NC, United States

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.