Aggressive ulcerative necrobiosis lipoidica associated with venous insufficiency, giant-cell phlebitis and arteritis

A case of aggressive ulcerative necrobiosis lipoidica affecting the shins of a 54-year-old woman is described. It proved completely refractory to medical and surgical treatments and circumferential ulceration ultimately necessitated amputation of one leg above the knee. Coexistent venous insufficiency from past deep vein thromboses and local giant-cell phlebitis and arteritis with obstruction of vessels of both types, are considered to have militated against healing of the extensive and chronic ulceration.