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Necrobiosis Lipoidica — SCE Dermatology MCQ

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HardInflammatory DermatosesNecrobiosis LipoidicaSCE Dermatology

A longstanding pretibial plaque of necrobiosis lipoidica develops a persistent ulcer with a new hyperkeratotic, indurated edge. What is the priority next step?

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Correct answer: E — Biopsy the altered edge to exclude squamous carcinoma

Chronic ulcerated necrobiosis lipoidica can rarely develop squamous cell carcinoma. A new indurated or hyperkeratotic edge is a red flag requiring biopsy rather than further empirical anti-inflammatory treatment.

Reference: https://academic.oup.com/bjd/pages/bad-guidelines