Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Department of Dermatology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
J Cutan Pathol. 2022 Aug;49(8):692-700. doi: 10.1111/cup.14238. Epub 2022 Apr 25.
Necrobiosis lipoidica (NL) is an uncommon granulomatous dermatosis that can occur in patients with or without associated diabetes mellitus (DM). Prior studies have attempted to determine distinctive histopathologic features of NL in patients with and without DM.
A retrospective review of 97 patients with NL was performed to determine the similar and distinctive histopathologic features in patients with DM and without DM.
Of the 97 patients, 32% (n = 31) had DM. Epidermal acanthosis was seen more commonly in diabetics than nondiabetics (32.3% vs. 12.1%; p = 0.017). Naked (sarcoidal/tuberculoid) granulomas were more frequently observed in nondiabetics than diabetics (22.7% vs. 3.2%; p = 0.016). Eosinophils were more common in nondiabetics than diabetics (38.5% vs. 9.7%; p = 0.004), while neutrophilic infiltration was more common in diabetics than nondiabetics (45.2% vs. 17.5%; p = 0.004).
This study corroborates well-documented histopathologic features of NL and shows distinctive histopathologic features of NL among patients with DM-I, DM-II, and without DM. These results support the hypothesis that there are different underlying drivers of NL between diabetics and nondiabetics.
脂性渐进性坏死（NL）是一种不常见的肉芽肿性皮肤病，可发生于有或无伴发糖尿病（DM）的患者中。既往研究曾尝试确定 DM 患者与非 DM 患者 NL 的独特组织病理学特征。
对 97 例 NL 患者进行回顾性研究，以确定 DM 患者与非 DM 患者的相似和独特组织病理学特征。
97 例患者中，32%（n=31）患有 DM。与非 DM 患者相比，糖尿病患者中更常见表皮棘皮症（32.3%比 12.1%；p=0.017）。非糖尿病患者中更常观察到裸（类肉瘤样/结核样）肉芽肿（22.7%比 3.2%；p=0.016）。非糖尿病患者中嗜酸性粒细胞比糖尿病患者更常见（38.5%比 9.7%；p=0.004），而中性粒细胞浸润在糖尿病患者中比非糖尿病患者更常见（45.2%比 17.5%；p=0.004）。
本研究证实了 NL 有明确的组织病理学特征，并表明 DM-I、DM-II 患者与非 DM 患者的 NL 存在独特的组织病理学特征。这些结果支持 NL 在糖尿病患者和非糖尿病患者中存在不同潜在驱动因素的假说。
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