Photogallery: necrobiosis lipoidica, granuloma annulare

Necrobiosis lipoidica andgranulomaannulare arerarechronicconditionsthatbelongto the group of non–infectious(inflammatory)skindiseases.[Daccache J.et al.,2024].

Necrobiosis lipoidica (NL)manifests itself in the form of papulesandplaques of brightpinkcolor,whichtransforminto ring-shaped,redoryellowishplaques,may be accompanied by the appearance of telangiectasia,centralatrophy,indurationandulceration.Granulomaannulare (GA)isasingle ring-shapedplaqueordisseminatedskinlesionin the form of papules,spotsand ring-shapedfoci of brightpinkcolor.

NLandGA are oftenobserved in patientswithconcomitantdiseasessuchasdiabetesmellitus type 1and type 2,MODYdiabetes,endocrinopathies(pathology of the thyroidgland,adrenal glands), and chronicupperrespiratorytractinfection. The frequentregistration of comorbidconditionsindicatestheneed to choose an interdisciplinaryapproachto the treatment of the aboveconditions.

Local,systemictherapyandphysiotherapymethods are usedtotreatNLandGA.Topicaltreatmentconsistsin the use of topicalglucocorticosteroids(GCS)andcalcineurininhibitors.Whenchoosing a systemictherapytactic, systemicGCS are used.Theresearchers also reporton the use of chloroquine,hydroxychloroquine,fumaricacidestersandgeneticallyengineeredbiologicaltherapy. A variety of physiotherapymethodsincludesUVA,UVB,PUVAtherapy, the use of CO2laser,dyelaserandintensepulsedlight(IPLtherapy).However,unfortunately,ofall the therapiesproposedtodate,noneofthemshowabsoluteeffectivenessand,moreimportantly,long-term remissionisextremelyrare.

We present a photogallery of the variability of clinical manifestations of necrobiosis lipoidica and granuloma annulare.