Necrobiosis lipoidica in a Nigerian woman - Report of a case.

Necrobiosis lipoidica (NL), one of a group of "necrobiotic" granulomatous cutaneous disorders, is characterized histologically by layers of poorly defined, horizontally oriented, altered "necrobiotic" collagen surrounded by, and alternating with, layers of chronic inflammatory cells, histiocytes, and giant cells throughout the full thickness of the dermis. It is a rare disease associated mostly with diabetes mellitus in whom it may affect 0.3%-1.2% although it has also been associated with other cutaneous and systemic disorders and may occur in otherwise normal people. NL has been reported from all over the world, but there appears to be very few reports of NL in Black Africans. We report the case of a 55-year-old diabetic Nigerian woman who presented with typical NL lesions on the lower legs and who responded very well to topical betamethasone dipropionate 0.05% cream. We also briefly review the probable underlying mechanisms leading to the condition and the various treatments that have been found useful.