Resolution of Long-Standing Necrobiosis Lipoidica Diabeticorum (NLD) Lesion After Restoration of Euglycemia Following Successful Pancreas After Kidney (PAK) Transplantation: A Case Report

• Published in: Transplantation proceedings Vol. 43; no. 9; pp. 3296 - 3298
• Main Authors: Mazur, M.J, Lowney, A.C, Prigoff, J, Heilman, R.L, Chakkera, H, Moss, A, Mulligan, D, Reddy, K, Hamawi, K
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.11.2011; Elsevier
• Subjects: Biological and medical sciences; Blood Glucose - metabolism; Dermatology; Diabetes Complications - therapy; Diabetes Mellitus, Type 1 - therapy; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunosuppressive Agents - therapeutic use; Inflammation; Kidney Transplantation - methods; Medical sciences; Middle Aged; Necrobiosis Lipoidica - complications; Necrobiosis Lipoidica - therapy; Pancreas Transplantation - methods; Skin involvement in other diseases. Miscellaneous. General aspects; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Treatment Outcome; Necrobiosis lipoidica; Human; Skin disease; Transplantation; Homotransplantation; Kidney; Case study; Medicine; Treatment; Urinary system; Combined surgery; Restoration; Graft; Lesion; Pancreas
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.10.005

Abstract Necrobiosis lipoidica diabeticorum (NLD) is an inflammatory skin disorder of unknown cause which can be seen in patients with diabetes mellitus. Various treatments, including immunosuppressive agents have been tried, without consistent efficacy. NLD is generally thought not to correlate well with tight diabetic control. Pancreas transplantation is the only widely and clinically used treatment that restores euglycemia in type I diabetic recipients. We report a case of resolution of NLD that had been unchanged for decades before pancreas after kidney transplantation. Another unique aspect of our case was that immunosuppression was discounted as a confounding factor, because the patient had been exposed to the same antirejection regimen for 3 years preceding the pancreas transplantation.