Treatment

Seek specialist advice.

• if non-ulcerated necrobiosis lipoidica (NL) then possible treatment measures include topical corticosteroids (e.g. application of steroid creams under occlusive dressings); also intralesional and systemic corticosteroids are possible treatment modalities (1). Topical PUVA appears to be a promising therapeutic option in the treatment of non-ulcerated NL
• steroid use is beneficial to control the initial erythema in early lesions but fails to help with the atrophic component of the lesions and can worsen atrophy (2)
• if ulcerated NL then there may be response to immunomodulating drugs such as cyclosporin and mycophenolate mofetil

Reference:

1. British Journal of Diabetes and Vascular Disease 2005; 5(1):37-41.
2. Duff M et al. Cutaneous Manifestations of Diabetes Mellitus.Clin Diabetes. 2015 Jan; 33(1): 40-48.