{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:51:13Z","timestamp":1787187073081,"version":"build-2736575974"},"reference-count":113,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005297","name":"Medical University of Bia\u0142ystok","doi-asserted-by":"publisher","award":["B.SUB.24.450"],"award-info":[{"award-number":["B.SUB.24.450"]}],"id":[{"id":"10.13039\/501100005297","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Necrobiosis lipoidica (NL) is a rare granulomatous disease of a not fully understood etiopathogenesis. Classically, NL is associated with insulin-dependent diabetes mellitus. The disease often fails to respond to conventional treatments and adversely affects patients\u2019 quality of life. First-line medications are usually topical corticosteroids, but patients respond to them with varying degrees of success. Other options include tacrolimus, phototherapy, cyclosporine, fumaric acid esters, and biologics (adalimumab, etanercept, and infliximab). Our review aims to present new therapeutic approaches potentially effective in patients with refractory lesions, describe the presumed etiopathogenesis, and provide diagnostic guidance for clinicians. The review concludes that Janus kinase inhibitors and biologics such as ustekinumab and secukinumab can be used effectively in patients with recalcitrant NL. Another promising treatment option is tapinarof (an aryl hydrocarbon receptor agonist). However, studies on larger groups of patients are still needed to evaluate the effectiveness of different therapeutic options and to define consistent treatment regimens for NL. It is advisable to improve the awareness of physicians of various specialties regarding necrobiosis lipoidica as lesions diagnosed earlier usually have a better response to treatment.<\/jats:p>","DOI":"10.3390\/ijms25063482","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T05:04:12Z","timestamp":1710911052000},"page":"3482","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A Breakthrough in the Treatment of Necrobiosis Lipoidica? Update on Treatment, Etiopathogenesis, Diagnosis, and Clinical Presentation"],"prefix":"10.3390","volume":"25","author":[{"given":"Maciej","family":"Naumowicz","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2448-1190","authenticated-orcid":false,"given":"Stefan","family":"Modzelewski","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Macko","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartosz","family":"\u0141uniewski","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8018-9960","authenticated-orcid":false,"given":"Anna","family":"Baran","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5923-910X","authenticated-orcid":false,"given":"Iwona","family":"Flisiak","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1001\/archderm.1966.01600250007001","article-title":"Necrobiosis lipoidica diabeticorum histopathologic study of 98 cases","volume":"94","author":"Muller","year":"1966","journal-title":"Arch. 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