Loading
Skin Diseases and Diabetes · Journal article
Cureus · August 10, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report of a 50-year-old male with necrobiosis lipoidica presenting with ulcerative lesions misdiagnosed as infectious disease, resulting in two years of unnecessary antibiotics and surgery before correct diagnosis and treatment with steroids and immunologics. The report illustrates diagnostic delay and the importance of histopathologic examination, but provides no comparative or quantitative evidence on treatment efficacy or outcomes.
Case report. 50-year-old male with necrobiosis lipoidica presenting with ulcerative skin lesions initially misdiagnosed as infectious disease. Intervention: Steroids and immunologic agents.
Patient underwent antibiotic treatment for approximately two years and multiple surgical debridements with skin grafting before NL diagnosis was made After diagnosis, treatment with steroids and immunologics improved symptoms significantly NL has higher incidence in diabetic patients than general population
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
This case highlights the diagnostic challenge of necrobiosis lipoidica and the risk of prolonged inappropriate treatment when the condition is not recognized. Clinicians should maintain awareness that chronic, antibiotic-resistant ulcerative lesions may warrant histopathologic examination to exclude autoimmune etiologies.
A single case report describing diagnostic delay and treatment response in necrobiosis lipoidica; demonstrates clinical presentation but lacks comparative data, control group, or systematic evidence on efficacy.
As stated by the source record.
Quoted from the source exactly as published.
This case highlights the diagnostic challenge of necrobiosis lipoidica and the risk of prolonged inappropriate treatment when the condition is not recognized. Clinicians should maintain awareness that chronic, antibiotic-resistant ulcerative lesions may warrant histopathologic examination to exclude autoimmune etiologies.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Necrobiosis lipoidica (NL) is a rare, granulating autoimmune disease that can be quite difficult to diagnose. It has a higher incidence in diabetic patients than in the general population. Diagnosis often depends upon both clinical and histopathologic examinations. It has a frequent association with diabetes, metabolic syndrome (obesity, hypertension, high cholesterol), and thyroid diseases. This is the case of a 50-year-old male patient who developed ulcerative skin lesions that were refractory to antibiotic therapy. He underwent antibiotic treatments for about two years, as well as multiple surgical debridement with skin grafting. However, the lesions continued to recur. Finally, after two years, a diagnosis of NL was made. He was subsequently prescribed steroids and immunologics, which improved his symptoms significantly. NL treatment is determined by whether the lesions are ulcerative or not. Typically, management will begin with topical corticosteroids and advance to systemic treatments as indicated. Surgical interventions are generally not recommended, as this disease is known to have pathergy. NL is a rare disease that is difficult to diagnose. It can be mistaken for an infectious etiology, like in our case. Due to the difficulty in diagnosing the disease, treatment can be delayed and, in turn, result in unintended harm to the patient with unnecessary procedures. In the future, there should be further investigation into the pathogenesis of this disease and advancement of diagnostic tools for earlier, accurate diagnosis.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.