[Extracrural manifestation of necrobiosis lipoidica. Isolated involvement of the head].

Necrobiosis lipoidica confined to the face and scalp is very rare. The clinical diagnosis is complicated by the granuloma anulare like aspect and in particular by the lack of typical localization of the extremities. Histologically prominent granulomatous dermal proliferation and less marked vascular changes can often be found in the involved areas of the scalp and/or in the absence of diabetes mellitus. For the microscopic classification the large variability of necrobiosis lipoidica must be considered. In our case with an exclusive localization in the face and capillitium, diabetes mellitus was excluded. The necrobiotic type of the necrobiosis lipoidica was predominant. The identity between necrobiosis lipoidica with other chronic granulomatous diseases and the possible treatment of this benign but long-term process is briefly discussed.