Nakajima Takeshi, Tanemura Atsushi, Inui Shigeki, Katayama Ichiro
Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, Osaka, Japan.
J Dermatol. 2009 Mar;36(3):166-9. doi: 10.1111/j.1346-8138.2009.00612.x.
The pretibial area is the most frequently affected site in necrobiosis lipoidica (NL), but proposed mechanisms of NL cannot fully explain this high frequency. Although a few case reports indicate NL patients are complicated with venous insufficiency, no accurate assessment of the relationship between these two conditions has been performed. By using color Doppler ultrasonographic screening of four NL patients for venous insufficiency, we detected venous insufficiency in at least one leg of each patient. NL lesions were observed on all legs with venous insufficiency, and laboratory examination findings revealed that all the patients had hypercholesterolemia. The skin lesions did not respond satisfactorily to 6-month use of anticholesterolemic medication and elastic stockings. However, these results indicate that both hyperlipidemia and venous reflux, in addition to other pathogenic factors, can trigger tissue damage in the lower legs and lead to the onset of NL.
胫前区域是脂性渐进性坏死（NL）最常受累的部位，但NL的发病机制尚不能完全解释为何该部位受累频率如此之高。尽管有少数病例报告表明NL患者合并静脉功能不全，但尚未对这两种情况之间的关系进行准确评估。通过对4例NL患者进行彩色多普勒超声检查以筛查静脉功能不全，我们发现每位患者至少有一条腿存在静脉功能不全。在所有存在静脉功能不全的腿部均观察到NL病变，实验室检查结果显示所有患者均有高胆固醇血症。使用抗胆固醇药物和弹力袜6个月后，皮肤病变并未得到令人满意的改善。然而，这些结果表明，除其他致病因素外，高脂血症和静脉反流均可引发小腿组织损伤并导致NL的发生。
