Objectives: Necrobiosis lipoidica is a rare degenerative disease of dermal connective tissue usually observed in young diabetic patients. Several drugs have been suggested to be useful, but none have been shown to be effective in all cases.
Case report: A young patient with insulin-dependent diabetes had a severe invalidating ulcerated necrobiosis lipoidica. Oral corticosteroids led to a satisfactory regression then stabilization with 6 mg/d prednisone.
Discussion: Oral corticosteroids would appear to be effective treatment and should be validated by controlled studies. Corticosteroids should only be used in exceptionally severe forms of ulcerated necrobiosis lipoidica after failure of conventional treatments. Diabetes would be an indication under strict metabolic control.