Jahr U, Sodemann K, Kirsch G, Mehnert E
Z Gesamte Inn Med. 1979 Nov 15;34(22):681-5.
For the judgment of the peripheral blood supply 16 insulin-dependent diabetics with necrobiosis lipoidica at the lower extremities were compared with 15 insulin-dependent diabetics without necrobiosis lipoidica. The vascular changes in form of retinopathy, nephropathy, neuropathy, hypertension, the results of the radiologically provable vascular changes, oscillograms and impedance plethysmograms as well as the results of the muscle and skin clearance and angioscintigraphy were evaluated. The at last mentioned methods give an insight into the microangiopathy. The apparantly contradicting findings of the muscle clearance (smaller blood supply) and of the skin clearance (increased blood flow) find their explanation by the angioscintigraphically proved different regional parameters of blood flow in the necrobiotic regions. The angiopathic findings are characterized by the enrichment of activity in the marginal seam as a sign of hyperemia and decreased accumulation in the centre as an expression of necrobiosis. The changes of the connective tissue and their causes of development are discussed. Angiopathic and traumatic influences conditioned by metabolism, apart from local peculiarities are taken into consideration.