Madatli A. H.

PROMISING THERAPEUTIC APPROACHES FOR LIPOID NECROBIOSIS

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About the author:

Madatli A. H.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Lipoid necrobiosis is a rare chronic dermatosis belonging to the group of localized cutaneous lipidoses. Its pathogenesis is closely associated with disorders of lipid and carbohydrate metabolism, microangiopathic changes, tissue hypoxia, impaired collagen degeneration, and alterations in the haemostatic system. Clinically, the disease is characterized by firm papules and plaques with a yellowish atrophic centre and a reddish-violet inflammatory peripheral rim, reflecting a persistent degenerative and inflammatory process in the dermis. The aim of the study was to evaluate the therapeutic potential of different treatment regimens for lipoid necrobiosis, with particular emphasis on Angipars, by assessing changes in lipid profile, carbohydrate metabolism, coagulation parameters, and the clinical intensity of the inflammatory border of the lesions. The study included 36 patients with lipoid necrobiosis who were observed at specialized dermatological clinical centres in Baku between 2015 and 2020. The patients were divided into three equal groups of 12 individuals. Group I received Angipars as monotherapy. Group II was treated with Angipars in combination with conventional therapy, including angioprotective agents, proteolytic preparations, and hepatoprotectors. Group III received conventional therapy alone. The assessment included total cholesterol, triglycerides, LDL, HDL, glycated haemoglobin, glucose, insulin, and coagulation parameters. Clinical efficacy was additionally evaluated by objective examination of the inflammatory peripheral rim of necrobiosis plaques before and after treatment. The results demonstrated that Angipars, particularly when combined with conventional therapy, contributed to improvement of lipid metabolism and reduction of inflammatory activity in the lesions. The most pronounced clinical effect was observed in Group II, where the inflammatory peripheral rim almost completely regressed in the majority of patients. No statistically significant changes were found in carbohydrate metabolism or coagulation parameters after treatment. Thus, the inclusion of Angipars in the complex therapy of lipoid necrobiosis is a pathogenetically justified and promising treatment approach that contributes to the improvement of microcirculation and reduction of inflammatory manifestations of the disease.

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Bibliography:

1. Loqunov P.V. Kliniko-patoheneticheskiye osobennosti porajeniya koji pri sakharnom diabete. Torsuevskiye chteniya. 2022;2(36):21-7.
2. Makhmudov FR, Mamadqasanov RM, Madatli AN. Kojniye proyavleniya pri lipoidnom nekrobioze. Azerbayjan Medical Journal. 2023;1:76-80.
3. Barnes CJ, Davis LS. Necrobiosis Lipoidica. Endocrinology. 2024. Available from: https://emedicine.medscape.com/article/1103467-overview
4. Naumowicz M, Modzelewski S, Macko A, Łuniewski B, Baran A, Flisiak I. A breakthrough in the treatment of necrobiosis lipoidica? update on treatment, etiopathogenesis, diagnosis, and clinical presentation. International Journal of Molecular Sciences. 2024;25(6):3482.
5. Hashemi DA, Brown-Joel ZO, Tkachenko E, Nelson CA, Noe MH, Imadojemu S, et al. Clinical features and comorbidities of patients with necrobiosis lipoidica with or without diabetes. JAMA Dermatol. 2019;155(4):455-459.
6. Kochet KA. Osobennosti uqlevodnoqo i lipidnoqo obmena u bolnikh lipoidnim nekrobiozom. Dermatolohiya i venerolohiya. 2018;1(79):28-30.
7. Teplyuk NP, Shimanovskiy NL, Varshavskiy VA, Korolyeva VS. Perspektivniye napravleniya v izuchenii patoheneza lipoidnoqo nekrobioza. RJ kojnikh i venericheskikh bolezney. 2020;23(1):23-28.
8. Lepe K, Riley CA, Hashmi MF, Salazar FJ. Necrobiosis Lipoidica. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459318/
9. Kudrina MI, Makarenko LA. Lipoidniy nekrobioz v praktike terapevta i dermatoloha. Klinicheskaya medisina. 2013;4:62-4.
10. Qorbunov VV, Romanenko KV, Kolesnikova IA, Dyudyun AD. Klinicheskiy sluchay lipoidnoqo nekrobioza. Dermatolohiya. Kosmetolohiya. Seksopatolohiya. 2017;1-4:216-21.
11. Sorokina EV, Vladimirova EV, Akhmatova NK, Markova YuA, Mitrofanova NN, Qolovina AI. Lipoidniy nekrobioz. Poiski vozmojnostey upravleniya immunnim otvetom. Klinicheskaya dermatolohiya i venerolohiya. 2022;21(1):23-8.
12. Nihal A, Caplan AS, Rosenbach M, Damsky W, Mangold AR, Shields BE. Treatment options for necrobiosislipoidica: a systematic review. Int J Dermatol. 2023;62(12):1529-1537. DOI: https://doi.org/10.1111/ijd.16856
13. Erfurt-Berge C, Heusinger V, Reinboldt-Jockenhöfer F, Dissemond J, Renner R. Comorbidity and therapeutic approaches in patients with necrobiosis lipoidica. Dermatology. 2022;238(1):148-55.

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 2, 181, 184-188 pages, index UDC 615.5-002.4-085.835.3

DOI:

10.29254/2077-4214-2026-2-181-184-188