Squamous Cell Carcinoma Arising in Long-standing Necrobiosis Lipoidica

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Abstract
To the Editor.— Although the development of squamous cell carcinoma at sites of chronic skin damage is a well-recognized phenomenon, to our knowledge there is only one previous report in the literature of its appearing in an area of necrobiosis lipoidica. We would like to report another case. Report of a Case.— A 59-year-old woman had suffered from insulin-dependent diabetes mellitus since 1932. In 1944, extensive necrobiosis lipoidica of the legs and feet developed, and, in 1947, granuloma annulare of the hands. The granuloma annulare cleared but the necrobiosis lipoidica persisted and extended. Ulceration of the lesions first occurred in 1975 but healed in a few months. In 1977, an ulcer developed above the right lateral malleolus in an area of necrobiosis lipoidica that had been noted by a dermatologist in 1944 and recorded on several occasions since. This ulcer persisted and continued to enlarge despite four months' inpatient treatment

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