Since our report1 on necrobiosis lipoidica diabeticorum was made in 1934 we have carefully scrutinized the literature for articles on the subject and have observed four additional patients who had diabetes with this complicating cutaneous manifestation. The title which Urbach2 conferred on the condition seems to have been generally accepted. It is still our opinion that, pathogenetically, necrobiosis lipoidica diabeticorum is closely related to diabetic gangrene on account of the underlying vascular disturbance, that it is allied somewhat to xanthoma on account of the deposit of lipoids and that it is frequently difficult to draw sharp lines of demarcation microscopically between the two conditions. Further observation has also convinced us that trauma plays an important part in the pathogenesis. A review of the literature since the publication of our article reveals the report of Klaber,3 who presented before the Royal Society of Medicine a 36