Necrobiosis Lipoidica (नेक्रोबियोसिस लिपोइडिका / NL) एक rare chronic skin disorder है जिसमें collagen degeneration और inflammation होता है।
- Skin lesions आमतौर पर lower legs (shin area) पर दिखाई देते हैं।
- Condition slowly progressive होती है और कभी-कभी ulceration (skin break) भी कर सकती है।
- अधिकतर cases में diabetes mellitus के साथ associated पाया जाता है।
Necrobiosis Lipoidica क्या है (What is Necrobiosis Lipoidica)
- Chronic granulomatous skin disease
- Characterized by yellow-brown, shiny plaques with telangiectasia
- Lesions may become atrophic or ulcerate over time
- Usually affects shin, sometimes forearms or hands
- Strong association with type 1 diabetes, occasionally type 2 diabetes
Necrobiosis Lipoidica कारण (Causes of Necrobiosis Lipoidica)
1. Diabetes Mellitus
- 60–75% of NL patients have diabetes
- Microvascular changes in diabetes may trigger lesions
2. Microangiopathy / Vascular Changes
- Small blood vessel damage leading to collagen degeneration and inflammation
3. Immune-Mediated Factors
- Chronic inflammatory reaction in dermis
- Autoimmune component possible
4. Other Risk Factors
- Obesity, hypertension, and poor glycemic control
- Trauma to affected skin area
Necrobiosis Lipoidica लक्षण (Symptoms of Necrobiosis Lipoidica)
- Well-defined, yellowish-brown plaques
- Shiny surface with telangiectasia (visible small blood vessels)
- Lesions mostly on shin (lower legs)
- Rarely itchy or painful
- Advanced lesions: atrophy, ulceration, and slow healing
- Slow progression over months to years
Skin lesions are usually asymptomatic initially, but ulceration increases risk of infection।
Necrobiosis Lipoidica कैसे पहचाने (Diagnosis of Necrobiosis Lipoidica)
- Clinical Examination – typical shiny, yellow-brown plaques on shin
- Skin Biopsy – confirms degeneration of collagen, granulomatous inflammation
- Blood Tests – check for diabetes mellitus or poor glycemic control
- Dermatoscopy – to assess surface changes and telangiectasia
- Rule out other conditions – granuloma annulare, sarcoidosis, cutaneous lupus
Histopathology is gold standard for definitive diagnosis।
Necrobiosis Lipoidica इलाज (Treatment of Necrobiosis Lipoidica)
1. Topical Therapy
- High-potency corticosteroids – reduce inflammation
- Calcineurin inhibitors (tacrolimus) – in steroid-resistant cases
- Emollients – for skin hydration and comfort
2. Systemic Therapy
- Oral corticosteroids in extensive or ulcerated lesions
- Immunosuppressive therapy in severe cases (methotrexate, cyclosporine)
- Glycemic control is essential in diabetic patients
3. Wound Care for Ulcerated Lesions
- Regular cleaning and dressing
- Avoid trauma to affected area
- Antibiotics if secondary infection occurs
4. Phototherapy / Laser Therapy
- Rarely used for cosmetic improvement or non-healing lesions
Treatment is mostly symptomatic; complete cure is difficult.
रोकथाम (Prevention)
- Strict glycemic control in diabetic patients
- Avoid trauma to lower legs
- Regular skin inspection for early lesions
- Healthy lifestyle: diet, exercise, blood sugar monitoring
सावधानियाँ (Precautions)
- Prompt treatment of any ulcer or infection
- Avoid scratching or rubbing plaques
- Regular dermatology follow-up
- Monitor for skin changes or new lesions
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. Necrobiosis Lipoidica contagious है?
नहीं, यह non-infectious skin disorder है।
Q2. क्या यह केवल diabetics में होता है?
अधिकतर cases में diabetes associated है, लेकिन non-diabetics में भी हो सकता है।
Q3. क्या lesions permanent हैं?
हाँ, lesions अक्सर slowly progressive और chronic होते हैं। Ulceration या atrophy develop कर सकती है।
Q4. क्या lifestyle changes मदद करते हैं?
हाँ, especially glycemic control और skin care lesions की progression को slow कर सकते हैं।
निष्कर्ष (Conclusion)
Necrobiosis Lipoidica (नेक्रोबियोसिस लिपोइडिका) एक chronic granulomatous skin disorder है, जो खासकर diabetic patients में common है।
Early detection, glycemic control, topical/systemic therapy और proper wound care से lesions की complications और ulceration कम की जा सकती है।
अगर किसी को shiny yellow-brown plaques या slow-healing ulcers दिखाई दें, तो dermatologist से consultation जरूरी है।