{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:53:08Z","timestamp":1769205188888,"version":"3.49.0"},"reference-count":43,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Necrobiosis lipoidica (NL) is complicated by ulceration in up to 35% of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective study of patients with NL seen at our institution between January 1, 1992, and May 25, 2021, was conducted. Ulcerated NL (UNL, <jats:italic>n<\/jats:italic>\u00a0=\u00a083) and non\u2010ulcerated NL (NUNL, <jats:italic>n<\/jats:italic>\u00a0=\u00a0233) groups were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010six percent (83\/316) of patients with NL experienced ulceration. UNL was significantly more likely to be painful (52% vs. 36%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), was more likely to have a lesion\u2010associated cutaneous malignancy (7% vs. 0%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and had a larger median size (7 vs. 5\u2009cm, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004) compared to NUNL. Vascular studies were performed on a subset of patients and revealed transcutaneous oxygen pressure (TcPO2)\u2009&lt;\u200940\u2009mm\u2009Hg in 53% and venous insufficiency in 62% with no significant differences between UNL and NUNL groups. In patients with unilateral ulceration, mean TcPO2 values (39.7 vs. 46.6\u2009mm\u2009Hg), regional perfusion index &lt;0.6 (29% vs. 14%), and TcPO2\u2009&lt;\u200940\u2009mm\u2009Hg (43% vs. 14%) were worse in the ulcerated leg compared to the non\u2010ulcerated leg, but these differences were not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>UNL was more likely to be painful, develop lesion\u2010associated malignancy, and be larger in size compared to NUNL. There were no statistically significant differences in venous insufficiency, arterial Doppler\/ankle brachial index, or TcPO2 values between UNL and NUNL patients, however, a significant portion of the cohort demonstrated abnormal vascular studies, particularly on TcPO2 and venous insufficiency testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.16529","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T19:54:36Z","timestamp":1670442876000},"page":"790-796","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Characteristics of ulcerated and non\u2010ulcerated necrobiosis lipoidica"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1928-9732","authenticated-orcid":false,"given":"Alexander","family":"Hines","sequence":"first","affiliation":[{"name":"Department of Dermatology Mayo Clinic  Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Butterfield","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Scottsdale AZ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4743-5530","authenticated-orcid":false,"given":"Blake","family":"Boudreaux","sequence":"additional","affiliation":[{"name":"Department of Dermatology Mayo Clinic  Scottsdale AZ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Puneet","family":"Bhullar","sequence":"additional","affiliation":[{"name":"Department of Dermatology Mayo Clinic  Scottsdale AZ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8650-3140","authenticated-orcid":false,"given":"Kevin J.","family":"Severson","sequence":"additional","affiliation":[{"name":"Department of Dermatology Mayo Clinic  Scottsdale AZ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert D.","family":"McBane","sequence":"additional","affiliation":[{"name":"Division of Vascular Medicine of Cardiovascular Diseases Mayo Clinic  Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark D. 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