The management of hard-to-heal necrobiosis with PROMOGRAN.

Nearly one third of patients with diabetes mellitus have some sort of dermatologic complication. Necrobiosis lipoidica diabeticorum (NLD) is a degenerative disease of the collagen in the dermis occurring in 0.3-0.7% of the diabetic population. There is no standard therapy for patients with NLD. The lesions associated with the condition appear as well circumscribed, erythematous plaques, with a depressed, waxy telangiectatic centre. One third of these lesions may progress to ulcers if exposed to any trauma. Management of these compromised wounds is often difficult, as NLD often goes through stages of activity and inactivity. This case study clearly illustrates some of the problems associated with wound management in a 34-year-old woman with an unhealed ulcer of 3 years' duration. Treatment with a new protease modulating matrix resulted in complete healing of the ulcer after 8 weeks, where other dressing regimens had failed to affect healing over a period of 2.5 years.