Necrobiosis Lipoidica Diabeticorum. Presented by Dr. Bertram Shaffer and (by invitation) Dr. M. Gray.
S. K., a white woman aged 57, obese, flushed, with apparent dulling of intellectual faculties, presents on the right leg, just above the calf, a circular lesion about 1 in. (2.5 cm.) in diameter, showing a firm, depressed center with telangiectases and a slightly raised, reddish-yellow border. On the medial aspect of the lower part of the leg there is a similar, smaller lesion with an ulcerated center.
The patient has had hypertension for over 10 years and diabetes for at least 5 years. She takes 20 to 26 units of insulin daily but has had no adequate medical control for several years. The cutaneous lesions appeared about two years ago.
A complete blood cell count revealed nothing remarkable. The fasting blood sugar was 235 mg. and the blood urea nitrogen 14.1 mg., per 100 cc.