Tip 1 Diyabetes Mellitus Tanılı Pediatrik Nekrobiyozis Lipoidika Olgusu

Yıl 2021, , 692 - 695, 24.09.2021

Dilara Güler , Gulhan Gurel , Çiğdem Özdemir

https://doi.org/10.20515/otd.881433

Öz

Nekrobiyozis lipoidika, etyolojisi ve patogenezi henüz net olarak bilinmeyen granülomatöz bir deri hastalığıdır. Diyabetes mellitus ve nekrobiyozis lipoidika komorbiditesi literatürde sıkça tartışılmakta olup mikroanjiyopatinin bu komorbiditede önemli bir role sahip olduğu düşünülmektedir. Nekrobiyozis lipoidika, diyabetes mellitus ile eş zamanlı ortaya çıkabilmekle beraber diyabetes mellitus tanısından önce veya sonra da ortaya çıkabilmektedir. Nekrobiyozis lipoidikanın kanıtlanmış etkin bir tedavisi bulunmamaktadır. Köbnerizasyon nedeniyle cerrahi tedavi önerilmemektedir. Burada yaklaşık 2 yıldır her iki alt ekstremitede multiple lezyonları olan ve yapılan punch biyopsi ile histopatolojik olarak nekrobiyozis lipoidika tanısı konulan 15 yaşında kız hasta sunuldu. Olgumuz ile nekrobiyozis lipoidika etyolojisi, kliniği ve tedavisi literatür ışığında değerlendirildi.

Anahtar Kelimeler

Nekrobiyozis Lipoidika, Diyabetes Mellitus, Pediatrik, Deri

A Case of Pediatric Necrobiosis Lipoidica with Type 1 Diabetes Mellitus

Öz

Necrobiosis lipoidica is a granulomatous skin disease of unknown etiology and pathogenesis. The comorbidity of diabetes mellitus and necrobiosis lipoidica is frequently discussed in the literature and it is thought that microangiopathy has an important role in this comorbidity. Although necrobiosis lipoidica may occur at the same time as diabetes mellitus, it may occur before or after the diagnosis of diabetes mellitus. There is no proven effective treatment for necrobiosis lipoidica. Surgical treatment is not recommended due to koebnerization. Here, we present a 15-year-old female patient who had multiple lesions in both lower extremities for about 2 years and was diagnosed histopathologically with necrobiosis lipoidica by punch biopsy. In this case report, the etiology, clinic and treatment of necrobiosis lipoidica were evaluated in the light of the literature.

Anahtar Kelimeler

Necrobiosis lipoidica;, Diyabetes mellitus, Pediatric, Skin

Kaynakça

• 1. Sibbald C, Reid S, Alavi A. Necrobiosis lipoidica. Dermatol Clin. 2015;33(3):343-60.
• 2. Lepe K, Salazar FJ. Necrobiosis lipoidica. In: StatPearls. StatPearls Publishing, Treasure Islands. 2020
• 3. MULLER SA, Winkelmann R. Necrobiosis lipoidica diabeticorum: a clinical and pathological investigation of 171 cases. Arch Dermatol. 1966;93(3):272-81.
• 4. McBriar D, Costley M, Houghton J, et al. Images of the month: A painful nodule arising within chronic necrobiosis lipoidica. Clin Med. 2020;20(6):e269.
• 5. Hawryluk EB, Izikson L, English JC. Non-infectious granulomatous diseases of the skin and their associated systemic diseases. Am J Clin Dermatol. 2010;11(3):171-81.
• 6. Lowitt MH, Dover JS. Necrobiosis lipoidica. J Am Acad Dermatol. 1991;25(5):735-48.
• 7. Fertitta L, Vignon-Pennamen M-D, Frazier A, et al. Necrobiosis lipoidica with bone involvement successfully treated with infliximab. Rheumatology. 2019.
• 8. Hashemi DA, Brown-Joel ZO, Tkachenko E, et al. Clinical features and comorbidities of patients with necrobiosis lipoidica with or without diabetes. JAMA Dermatol. 2019;155(4):455-9.
• 9. Imadojemu S, Rosenbach M. Advances in inflammatory granulomatous skin diseases. Dermatol Clin. 2019;37(1):49-64.
• 10. Dissemond J, Erfurt‐Berge C, Goerge T, et al. Systemic therapies for leg ulcers. J Dtsch Dermatol Ges. 2018;16(7):873-90.
• 11. Lause M, Kamboj A, Faith EF. Dermatologic manifestations of endocrine disorders. Transl Pediatr. 2017;6(4):300.