NECROBIOSIS LIPOIDICA DIABETICORUM - ASSOCIATION WITH BACKGROUND RETINOPATHY, SMOKING, AND PROTEINURIA - A CASE-CONTROLLED STUDY

In order to evaluate patients with necrobiosis lipoidica diabeticorum and to compare them with age, sex, and duration of diabetes matched co ntrols, 15 patients with necrobiosis were each matched with 5 control subjects with diabetes mellitus. Complications of diabetes, glycaemic control, and proteinuria were measured. Patients with necrobiosis (mea n age 40, range 18-74 years) had a mean duration of diabetes of 14 (ra nge 3-36) years; 8 patients were male, and 7 were female. For necrobio sis versus controls, background retinopathy (67 % vs 27, p = 0.009), p roteinuria (53 % vs 17 %, p = 0.006), and smoking (60 % vs 20 %, p = 0 .003) were all more common with necrobiosis. There were no significant differences between patients with necrobiosis and control patients in the prevalence of vascular disease and neuropathy. Glycosylated haemo globin concentrations were higher in patients with necrobiosis (p = 0. 02). Blood pressure measurements were similar in both groups. We concl ude that smoking, proteinuria, and retinopathy were more prevalent in diabetic patients with necrobiosis; the skin lesion may therefore shar e common aetiological factors which affect the microvascular circulati on, leading to damage to basement membranes and vascular endothelial c ells.