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Skin blood flow in necrobiosis lipoidica diabeticorum *
Author(s) -
Ngo Binh,
Wigington Greg,
Hayes Kristie,
Huerter Christopher,
Hillman Brandon,
Adler Matt,
Rendell Marc
Publication year - 2008
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2008.03549.x
Subject(s) - necrobiosis lipoidica , medicine , blood flow , laser doppler velocimetry , diabetes mellitus , ischemia , skin lesion , dermatology , pathology , endocrinology
Background Necrobiosis lipoidica diabeticorum (NLD) is a granulomatous skin reaction found in < 1% of diabetic patients. Our purpose was to determine if NLD represented areas of cutaneous ischemia. Methods Using laser Doppler flowmetry, we measured cutaneous blood flow in nine diabetic patients at NLD lesions and at contiguous uninvolved sites. Flow values were also determined at several reference sites noncontiguous with the NLD lesions and compared to age‐ and sex‐matched controls: 24 diabetic subjects without skin abnormalities, 18 diabetic patients with dermopathy, and 40 nondiabetic subjects. Results NLD lesions exhibited significantly higher blood flow (4.8 ± 0.7 ml/min/100 g) than areas of unaffected skin close to the lesions (1.2 ± 0.1 ml/min/100 g) ( P < 0.01 for both comparisons). There were no significant differences in flow between normal skin sites in NLD patients and normal sites in diabetic patients without skin lesions. Conclusions Our findings refute the hypothesis that NLD is a manifestation of microvascular ischemic disease of the skin. The increased blood flow seen in NLD lesions suggests an ongoing inflammatory process.