How is necrobiosis lipoidica treated?

Updated: Mar 06, 2020
  • Author: Cheryl J Barnes, MD; Chief Editor: George T Griffing, MD  more...
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Treatment for necrobiosis lipoidica is not very effective, partially because the exact etiology remains unknown. Because localized trauma can cause necrobiosis lipoidica to ulcerate, protection of the legs with elastic support stockings and leg rest may be helpful.

Topical and intralesional corticosteroids can lessen the inflammation of early active lesions and the active borders of enlarging lesions but have little beneficial effect on so-called “burned out” atrophic lesions. In fact, with atrophic lesions, corticosteroid use may cause further atrophy.

In 2005, Clayton and Harrison reported a case of ulcerated necrobiosis lipoidica that was treated successfully with 0.1% topical tacrolimus ointment applied twice daily for 1 month. [15] Tacrolimus is a calcineurin inhibitor that has been shown to have a mechanism of action similar to that of cyclosporine in that it prevents T-cell activation. Cyclosporine at doses of 2.5 mg/kg/day has also been used with success in treating ulcerated necrobiosis lipoidica. [16]

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