Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (647 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A degenerative disease of the dermal connective tissue characterized by the development of erythematous papules or nodules in the pretibial area. The papules form plaques covered with telangiectatic vessels. More than half of the affected patients have diabetes.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Necrobiosis Lipoidica Diabeticorum; Diabeticorum, Necrobiosis Lipoidica.
Where it fits in the MeSH classification
- Broader topics
- Necrobiotic Disorders; Skin Diseases, Metabolic
Research landscape
PubMed indexes 832 records tagged with the MeSH heading “Necrobiosis Lipoidica” (counts retrieved 2026-10-31). 65 of them (7.8%) were published from 2020 onward, and the busiest period so far is through 1999 with 490 records.
Reviews account for 93 records (11.2%) and meta-analyses for 1. Randomized controlled trials number 2 (0.2%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 490 |
| 2000-2009 | 120 |
| 2010-2019 | 157 |
| 2020 onward | 65 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 93 | 11.2% |
| Meta-analyses | 1 | 0.1% |
| Randomized controlled trials | 2 | 0.2% |
Method: PubMed query "Necrobiosis Lipoidica"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in metabolism and endocrine disease
Studies of diabetes, obesity and hormone disorders often follow blood tests such as glucose, HbA1c or hormone levels, which are stand-ins for outcomes that matter more, such as complications. Lifestyle and diet research is largely observational, and weight and diabetes trials can differ in how long people were followed. Nothing on this page is advice about medicines, insulin or diet; talk to a qualified clinician about your own situation. Check whether the outcome was a lab value or a clinical event, and the type and duration of the condition studied.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| A Breakthrough in the Treatment of Necrobiosis Lipoidica? Update on Treatment, Etiopathogenesis, Diagnosis, and Clinical Presentation | 2024 | Review article Design not recorded in structured metadata | 7 | cc by PMID 38542454 · DOI · PMC10970963 |
| Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap-a case report | 2023 | Research article Design not recorded in structured metadata | 4 | cc by PMID 36747272 · DOI · PMC9901077 |
| Necrobiosis lipoidica of the breast associated with Crohn's disease: a case report | 2023 | Research article Design not recorded in structured metadata | 2 | cc by PMID 36597169 · DOI · PMC9811805 |
| S1-Guideline for diagnosis and therapy of necrobiosis lipoidica | 2026 | Research article Design not recorded in structured metadata | 1 | cc by PMID 41420334 · DOI · PMC12968943 |
A Breakthrough in the Treatment of Necrobiosis Lipoidica? Update on Treatment, Etiopathogenesis, Diagnosis, and Clinical Presentation [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Necrobiosis lipoidica (NL) is a rare granulomatous disease of a not fully understood etiopathogenesis.
- Closing excerpt
- It is advisable to improve the awareness of physicians of various specialties regarding necrobiosis lipoidica as lesions diagnosed earlier usually have a better response to treatment.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (180 words)
Necrobiosis lipoidica (NL) is a rare granulomatous disease of a not fully understood etiopathogenesis. Classically, NL is associated with insulin-dependent diabetes mellitus. The disease often fails to respond to conventional treatments and adversely affects patients' quality of life. First-line medications are usually topical corticosteroids, but patients respond to them with varying degrees of success. Other options include tacrolimus, phototherapy, cyclosporine, fumaric acid esters, and biologics (adalimumab, etanercept, and infliximab). Our review aims to present new therapeutic approaches potentially effective in patients with refractory lesions, describe the presumed etiopathogenesis, and provide diagnostic guidance for clinicians. The review concludes that Janus kinase inhibitors and biologics such as ustekinumab and secukinumab can be used effectively in patients with recalcitrant NL. Another promising treatment option is tapinarof (an aryl hydrocarbon receptor agonist). However, studies on larger groups of patients are still needed to evaluate the effectiveness of different therapeutic options and to define consistent treatment regimens for NL. It is advisable to improve the awareness of physicians of various specialties regarding necrobiosis lipoidica as lesions diagnosed earlier usually have a better response to treatment.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 38542454 · DOI · PMC10970963
Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap-a case report [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundExtensive loss of soft tissue and bone due to neoplasia, trauma, or infection in extremities often leads to amputation.
- Closing excerpt
- In selected cases, the boundaries of limb salvage can be pushed far beyond the current standards of treatment.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (171 words)
BackgroundExtensive loss of soft tissue and bone due to neoplasia, trauma, or infection in extremities often leads to amputation.Case presentationWe present the case of a 72-year-old female patient presenting with an extended cutaneous squamous cell carcinoma of the lower leg, developed on top of necrobiosis lipoidica. After achieving the R0 resection, a 26 × 20-cm soft tissue and 15-cm tibial bone defect resulted. The contralateral leg had been lost due to the same disease 18 years before. We achieved a successful reconstruction of the leg using a pedicled fibula transplantation, an extended anterolateral thigh perforator flap, and an internal fixation with plate and screws. Two years after the original surgery, the patient is relapse-free and mobile, with adequate function of the reconstructed foot.ConclusionsOur case presented a unique combination of pedicled fibula transplantation and free extended ALT perforator flap to reconstruct an extensive defect after resection of a rare cSCC on top of NL. In selected cases, the boundaries of limb salvage can be pushed far beyond the current standards of treatment.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36747272 · DOI · PMC9901077
Necrobiosis lipoidica of the breast associated with Crohn's disease: a case report [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundNecrobiosis lipoidica located to the breast; without evidence of glucose intolerance, is extremely rare, and its association to Crohn's disease is not usual.
- Closing excerpt
- ConclusionsOn the basis of this rare observation, necrobiosis lipoidica without evidence of glucose intolerance should be recognized as a possible cutaneous manifestation or association of Crohn's disease.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (111 words)
BackgroundNecrobiosis lipoidica located to the breast; without evidence of glucose intolerance, is extremely rare, and its association to Crohn's disease is not usual.Case presentationWe report an interesting case of an association of necrobiosis lipoidica of the breast and Crohn's disease in a 54-year-old Moroccan woman. Skin necrobiotic changes are a characteristic feature in necrobiosis lipoidica, but they are exceptional in metastatic Crohn's disease, since there are only three published cases of necrobiotic skin lesions on the lower leg resembling erythema nodosum in metastatic Crohn's disease.ConclusionsOn the basis of this rare observation, necrobiosis lipoidica without evidence of glucose intolerance should be recognized as a possible cutaneous manifestation or association of Crohn's disease.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36597169 · DOI · PMC9811805
S1-Guideline for diagnosis and therapy of necrobiosis lipoidica [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Necrobiosis lipoidica (NL) is a rare granulomatous skin disease of unknown etiology that occurs frequently in association with diabetes mellitus and other comorbidities.
- Closing excerpt
- This short version of the S1 guideline of the German Dermatological Society (DDG) summarizes the current evidence and, incorporating expert assessments, provides specific recommendations for everyday clinical practice.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (185 words)
Necrobiosis lipoidica (NL) is a rare granulomatous skin disease of unknown etiology that occurs frequently in association with diabetes mellitus and other comorbidities. The predilection site is the lower leg, particularly the pretibial areas. The exact pathogenesis remains unclear. Vascular disorders with microangiopathic changes and an autoimmune genesis are discussed. Necrobiosis lipoidica occurs three to six times more frequently in women. Men tend to show a more severe course and develop ulcerations more frequently. The diagnosis can often be established based on typical clinical and dermatoscopic findings. A biopsy should be performed in clinically unclear cases, in the presence of ulceration, or if there are signs of malignant transformation. Overall, the scientific data available for NL are still insufficient and there is a need for further research. However, as patients often experience a severely impaired quality of life, it is important to be aware of the limited scientific evidence and to translate it into practical therapeutic recommendations. This short version of the S1 guideline of the German Dermatological Society (DDG) summarizes the current evidence and, incorporating expert assessments, provides specific recommendations for everyday clinical practice.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41420334 · DOI · PMC12968943
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Update on necrobiosis lipoidica: a review of etiology, diagnosis, and treatment options [5]
- Research article Necrobiosis lipoidica [6]
- Research article Cutaneous Granulomatosis: a Comprehensive Review [7]
- Research article Dimethyl fumarate - only an anti-psoriatic medication? [8]
- Research article Necrobiosis Lipoidica [9]
- Research article Necrobiosis lipoidica [10]
References
- Naumowicz M, Modzelewski S, Macko A, Łuniewski B, Baran A, Flisiak I. A Breakthrough in the Treatment of Necrobiosis Lipoidica? Update on Treatment, Etiopathogenesis, Diagnosis, and Clinical Presentation. . 2024. PMID 38542454 · DOI · PMC10970963
- Bota O, Meier F, Garzarolli M, Schaser KD, Dragu A, Taqatqeh F, et al.. Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap-a case report. . 2023. PMID 36747272 · DOI · PMC9901077
- Kelati A, Durupt F, Balme B. Necrobiosis lipoidica of the breast associated with Crohn's disease: a case report. . 2023. PMID 36597169 · DOI · PMC9811805
- Erfurt-Berge C, Renner R, Peckruhn M, Tittelbach J, Terhorst-Molawi D, Kauer F, et al.. S1-Guideline for diagnosis and therapy of necrobiosis lipoidica. . 2026. PMID 41420334 · DOI · PMC12968943
- Reid SD, Ladizinski B, Lee K, Baibergenova A, Alavi A. Update on necrobiosis lipoidica: a review of etiology, diagnosis, and treatment options. J Am Acad Dermatol. 2013. PMID 23969033 · DOI
- Lowitt MH, Dover JS. Necrobiosis lipoidica. J Am Acad Dermatol. 1991. PMID 1802895 · DOI
- Terziroli Beretta-Piccoli B, Mainetti C, Peeters MA, Laffitte E. Cutaneous Granulomatosis: a Comprehensive Review. Clin Rev Allergy Immunol. 2018. PMID 29352388 · DOI
- Meissner M, Valesky EM, Kippenberger S, Kaufmann R. Dimethyl fumarate - only an anti-psoriatic medication?. J Dtsch Dermatol Ges. 2012. PMID 22897153 · DOI
- Sibbald C, Reid S, Alavi A. Necrobiosis Lipoidica. Dermatol Clin. 2015. PMID 26143418 · DOI
- Peyrí J, Moreno A, Marcoval J. Necrobiosis lipoidica. Semin Cutan Med Surg. 2007. PMID 17544959 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.