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Sarcoidosis With Cutaneous Manifestations of Necrobiosis Lipoidica.

smooth muscle pattern with a round lumen and the intimal elastic fiber proliferation mimicking the characteristic features of arteritis.5 In the present case, the involved vessel was the muscular vein located at the dermo–subcutaneous junction. Magro et al6 suggested that the findings of active vasculopathy of leukocytoclastic, granulomatous, or thrombogenic subtypes in biopsied specimens of necrobiosis lipoidica or granuloma annulare should be considered as a manifestation of underlying systemic diseases. The pathogenesis of necrobiosis lipoidica is still uncertain; however, collagen degeneration, vascular changes, microangiopathy associated with diabetes, abnormalities in glucose transport by fibroblasts, impaired neutrophil migration, and inflammation triggered by altered metabolism or trauma have been speculated.7,8 Further studies regarding the association of granulomatous vasculitis with the clinical phenotypes of necrobiosis lipoidica are necessary.