What is the efficacy of medications used in the treatment of necrobiosis lipoidica?

Updated: Mar 06, 2020
  • Author: Cheryl J Barnes, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Double-blind studies of the treatment of necrobiosis lipoidica with aspirin and dipyridamole have had varied results but overall have shown some beneficial effects from the therapy. The treatment is based on a theory that necrobiosis lipoidica results from platelet-mediated vascular occlusion or immune mechanisms that alter platelet survival. [7] These drugs are thought to prolong platelet survival time and, hence, prevent further worsening of necrobiosis lipoidica.

Littler and Tschen described the successful use of pentoxifylline to treat a case of necrobiosis lipoidica. [30] Pentoxifylline inhibits platelet aggregation and is believed to decrease blood viscosity by increasing fibrinolysis and red blood cell deformity.

Uncontrolled studies have suggested that ticlopidine, [22] nicotinamide, [23] clofazimine, [24, 25] and perilesional heparin injections [26] can benefit some patients with necrobiosis lipoidica.


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