{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:25:07Z","timestamp":1777519507751,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Necrobiosis lipoidica (NL) is a rare chronic granulomatous disease that manifests as sharply demarcated, telangiectatic, brownish\u2010red plaques with atrophic yellowish centers prone to ulceration and occurs predominantly on the shins. In children, NL is extremely rare, but resistance to therapy, troublesome cosmetic appearance, painful ulcerations, and possible development of squamous cell carcinoma in long\u2010persisting lesions are challenges during treatment. Our review includes 29 reports of NL in patients aged &lt;18 years published from 1990 on PubMed, EMBASE, and Medline. The mean age of patients was 14.3\u00a0years, with a female predominance of 2\u00a0:\u00a01 and a high prevalence of diabetes mellitus (80%). Data showed that potent topical steroids up to twice daily is the first\u2010line treatment. For refractory cases, therapy can be switched to tacrolimus. Ulcerations benefit from phase\u2010adapted wound care and anti\u2010inflammatory medical dressings such as medical honey. Adding hyperbaric oxygenation to local or systemic therapy in difficult\u2010to\u2010treat ulcerated lesions can be considered. Refractory cases may be switched to topical photochemotherapy or systemic treatment with TNF\u2010\u03b1 inhibitors, systemic steroids (preferably in non\u2010diabetic patients), pentoxifylline, or hydroxychloroquine. Necrobiosis lipoidica in childhood is difficult to treat, with a treatment failure rate of 40%. Therefore, further research through patient registries is recommended.<\/jats:p>","DOI":"10.1111\/ddg.15137","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T06:17:33Z","timestamp":1688451453000},"page":"1120-1129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Necrobiosis lipoidica in childhood: a review of literature with emphasis on therapy"],"prefix":"10.1111","volume":"21","author":[{"given":"Anna","family":"Schiefer\u2010Niederkorn","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit","family":"Sadoghi","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Binder","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1966.01600210008002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.12749"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1999.02663.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(08)80961-9"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000514687"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1999.03081.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.05.034"},{"issue":"2","key":"e_1_2_8_9_1","first-page":"151","article-title":"Update: Therapie der Necrobiosis lipoidica","volume":"15","author":"Peckruhn M","year":"2017","journal-title":"J Dtsch Dermatol Ges"},{"issue":"7","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1111\/ddg.13586","article-title":"Systemic therapies for leg ulcers","volume":"16","author":"Dissemond J","year":"2018","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4081\/dr.2015.5749"},{"issue":"1","key":"e_1_2_8_12_1","first-page":"30","article-title":"Successful treatment of necrobiosis lipoidica with a combination of topical tretinoin and tacrolimus: A paediatric case report","volume":"38","author":"Thanopoulou I","year":"2021","journal-title":"Pediatr Dermatol"},{"issue":"7","key":"e_1_2_8_13_1","doi-asserted-by":"crossref","DOI":"10.5070\/D327754363","article-title":"Pediatric necrobiosis lipoidica: case report and review of the literature","volume":"27","author":"Berman HS","year":"2021","journal-title":"Dermatol Online J"},{"issue":"34","key":"e_1_2_8_14_1","article-title":"Rare skin condition in a child with diabetes mellitus","volume":"163","author":"Verhoeven MMR","year":"2019","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13716"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.15448\/1980-6108.2017.4.27149"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12872"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.08.080"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.12.014"},{"issue":"9","key":"e_1_2_8_20_1","first-page":"848","article-title":"Necrobiosis Lipoidica","volume":"53","author":"Dereci S","year":"2016","journal-title":"Indian Pediatr"},{"issue":"1","key":"e_1_2_8_21_1","first-page":"171","article-title":"Ulcerated necrobiosis lipoidica to a teenager with diabetes mellitus and obesity","volume":"55","author":"P\u0103tra\u015fcu V","year":"2014","journal-title":"Rom J Morphol Embryol"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2014.23.Sup2a.S12"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.4161\/derm.27790"},{"issue":"6","key":"e_1_2_8_24_1","first-page":"703","article-title":"Juvenile ulcerated necrobiosis lipoidica successfully treated with oral cyclosporin A","volume":"148","author":"Gualdi G","year":"2013","journal-title":"G Ital Dermatol Venereol"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ad.2012.04.022"},{"key":"e_1_2_8_26_1","article-title":"Necrobiosis lipoidica diabeticorum","volume":"2012","author":"Scaramuzza A","year":"2012","journal-title":"Case Rep Pediatr"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2010.01099.x"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000182259"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2005.01962.x"},{"issue":"7","key":"e_1_2_8_30_1","first-page":"589","article-title":"Necrobiosis lipoidica \u20133 case reports","volume":"61","author":"Mseddi M","year":"2006","journal-title":"Rev Med Liege"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/14746514050050010901"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2004.02120.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0007-0963.2004.05899.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1470.2003.20305.x"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2002.49735.x"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1470.2001.01935.x"},{"issue":"4","key":"e_1_2_8_37_1","first-page":"301","article-title":"Necrobiosis lipoidica in two children with insulin\u2010dependent diabetes mellitus","volume":"42","author":"Pinero Martinez E","year":"1995","journal-title":"An Esp Pediatr"},{"issue":"5","key":"e_1_2_8_38_1","first-page":"225","article-title":"Necrobiosis lipoidica diabeticorum in children. Description of a case","volume":"125","author":"Zaccone C","year":"1990","journal-title":"G Ital Dermatol Venereol"},{"key":"e_1_2_8_39_1","unstructured":"Schiefer\u2010NiederkornA BinderB.Ulcerating necrobiosis lipoidica in a child\u2010a therapeutic challenge.20th Annual Meeting of the European Society for Pediatric Dermatology.2021;38(Suppl1):67."},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-0267"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1995.tb00162.x"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12206"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.0345"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12159"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2020.29.6.321"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(98)00025-7"},{"issue":"6","key":"e_1_2_8_47_1","first-page":"141","article-title":"Honey: A biologic wound dressing","volume":"27","author":"Molan P","year":"2015","journal-title":"Wounds"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2014.23.Sup6.S30"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2016.06.003"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.5.9154873"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2012-0166"}],"container-title":["JDDG: Journal der Deutschen Dermatologischen Gesellschaft"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.15137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T01:38:47Z","timestamp":1697506727000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ddg.15137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,3]]},"references-count":50,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/ddg.15137"],"URL":"https:\/\/doi.org\/10.1111\/ddg.15137","archive":["Portico"],"relation":{},"ISSN":["1610-0379","1610-0387"],"issn-type":[{"value":"1610-0379","type":"print"},{"value":"1610-0387","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,3]]},"assertion":[{"value":"2022-09-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}