Necrobiosis lipoídica en paciente diabético tipo 1: reporte de un caso

Content Provider	Semantic Scholar
Author	Chiarpenello, Javier Baella, Ana Riccobene, A. Strallnicoff, Maia Fernández, Lorena Castagnani, Verónica Herrera, Melisa Zúñiga
Copyright Year	2014
Abstract	La necrobiosis lipoidica es una enfermedad cronica granulomatosa de la piel de origen desconocido, que se caracteriza por placas inflamatorias amarronadas con bordes indurados y centro atrofico. Dos tercios de los casos se reportan en pacientes diabeticos, con predominio en el sexo femenino. Se describe el caso de una mujer de 18 anos de edad con diagnostico de diabetes tipo 1 de mas de 15 anos de evolucion, en tratamiento con insulina detemir 88 U/dia, con inadecuada adherencia al tratamiento y mal control metabolico. Presento lesiones hipotroficas en cara anterior de ambas piernas (region pretibial derecha y antepie izquierdo), de centro ulcerado, no dolorosas, con bordes indurados, de meses de evolucion. Se realizo diagnostico de necrobiosis lipoidica mediante biopsia de piel. La paciente mejoro con tratamiento local de las lesiones (corticoides intralesionales y antibioticos topicos) y adecuado control de la glucemia. En la literatura se discuten numerosas opciones de tratamiento, pero no existen recomendaciones terapeuticas firmes basadas en estudios controlados. Necrobiosis lipoidica is a chronic granulomatous skin disease of unknown origin characterized by inflammatory plaques with indurated edges and brownish atrophic center. Two thirds of cases are reported in diabetic patients, with a predominance in females. The case of a 18-year-old woman with type 1 diabetes for 15 years is described; she was on insulin detemir 88 U/day, with inadequate adherence to treatment and poor metabolic control. She presented painless hypotrophic dermic lesions in the anterior aspect of both legs and in the left forefoot; they had ulcerated center and indurated edges; the evolution was chronic (several months). Diagnosis of necrobiosis lipoidica was made by skin biopsy. The patient improved with local treatment of lesions (intradermic steroids and topical antibiotics) and adequate glycemic control. In the literature many treatment options are discussed, but there are no firm therapeutic recommendations based on controlled studies.
Starting Page	33
Ending Page	36
Page Count	4
File Format	PDF HTM / HTML
Volume Number	80
Alternate Webpage(s)	http://www.circulomedicorosario.org/Upload/Directos/Revista/a1ecfeChiarpenello.pdf
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article