Cofactors and comorbidities of necrobiosis lipoidica: analysis of the German DRG data from 2012

J Dtsch Dermatol Ges. 2016 Mar;14(3):277-84. doi: 10.1111/ddg.12749.


Background: Necrobiosis lipoidica (NL) is a rare granulomatous inflammatory skin disease of unknown pathophysiology. Its potential association with diabetes mellitus is well known. Other relevant cofactors and comorbidities are subject to controversial debate.

Patients and methods: DRG (diagnosis-related groups) data of all inpatients with a coded primary or secondary diagnosis of NL treated at German hospitals in 2012 were evaluated.

Results: Data of 262 inpatient cases with the primary or secondary diagnosis of NL were analyzed. Women (63.4%; n = 166) were nearly twice as frequently affected as men (36.2%; n = 96). Most NL patients (14.8%) were in the age group between 50 and 55 years. Among comorbidities included in the metabolic syndrome complex, diabetes mellitus was the most common (34.4%; IDDM 20.6%, NIDDM 13.8%), while essential hypertension was observed in 9.2%, obesity in 4.6%, chronic heart failure in 4.1%, and dyslipidemias in 2.3% of cases. Leg ulcers were diagnosed in 7.3% of individuals; other venous disorders, in 5.7%.

Conclusions: Our data analysis describes one of the largest compilations of patient cases with the diagnosis of NL worldwide. Besides the well-known association with diabetes mellitus, there are numerous other potentially relevant cofactors and comorbidities that should be considered in the diagnosis and management of NL patients.

Keywords: DRG data; Necrobiosis lipoidica; cofactors; comorbidities; diabetes mellitus; leg ulcers.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Child
  • Comorbidity
  • Diagnosis-Related Groups / statistics & numerical data
  • Female
  • Germany / epidemiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Leg Ulcer / diagnosis
  • Leg Ulcer / epidemiology*
  • Male
  • Metabolic Diseases / diagnosis
  • Metabolic Diseases / epidemiology*
  • Middle Aged
  • Necrobiosis Lipoidica / diagnosis
  • Necrobiosis Lipoidica / epidemiology*
  • Obesity / diagnosis
  • Obesity / epidemiology*
  • Prevalence
  • Risk Factors
  • Sex Distribution
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / epidemiology*
  • Young Adult