Doxi para necrobiosis lipoidica

Published in Dermatology

Journal Scan / Case Study · August 04, 2020

Necrobiosis Lipoidica With Rapid Response to Doxycycline

Pediatric Dermatology

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• A 12-year-old girl with type 1 diabetes and biopsy-proven necrobiosis lipoidica was initially treated with several rounds of intralesional triamcinolone (7.5–30 mg per injection; 5- to 10-mg/mL concentration), topical clobetasol 0.05% ointment, and topical tacrolimus 0.3% ointment without success. Doxycycline monohydrate 100 mg twice daily was started for its anti-inflammatory effect, along with 10 to 15 mg intralesional triamcinolone injections. At 1 month, significant improvements in inflammation and induration were observed. After 3 months of doxycycline, there was resolution of subcutaneous atrophy caused by high-dose steroid injections (30 mg of 10-mg/mL concentration). The patient remains on doxycycline monotherapy for 4 months, with plans to taper over the next few months. The patient's glycemic control remained consistent while on topical and intralesional steroid therapy.

• This represents a successful case of treatment of necrobiosis lipoidica with doxycycline, which may have anti-inflammatory properties and inhibits matrix metalloproteinases that may impact tissue remodeling. Doxycycline may be a useful adjunctive treatment for necrobiosis lipoidica in patients with limited response to or side-effects from topical or intralesional steroids.

– InYoung Kim, MD, PhD

Abstract

Necrobiosis lipoidica (NL) is a rare granulomatous disease of unknown etiology. Multiple therapies may be used with varying efficacy. We report a pediatric patient with a history of type I diabetes mellitus and NL with minimal response to an ultrapotent topical steroid, topical calcineurin inhibitor, and intralesional triamcinolone, complicated by steroid atrophy, who rapidly responded after addition of doxycycline.

Pediatric Dermatology

Necrobiosis Lipoidica With Rapid Response to Doxycycline

Pediatr Dermatol 2020 Jul 18;[EPub Ahead of Print], E Burns, U Ukoha, A Chan

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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