title: Squamous cell carcinoma arising in an area of long-standing necrobiosis lipoidica.
abstract: BACKGROUND
  Squamous cell carcinoma in an area of chronic ulceration is a well-documented phenomenon. However, its occurrence arising de novo in an area of necrobiosis lipoidica is rare.
  
  
  METHODS
  We report a case in a 53-year-old female who presented with a 2 month history of an erythematous nodule occurring in a plaque of necrobiosis lipoidica on the medical aspect of the right lower leg. She had a background of poorly controlled Type 1 diabetes.
  
  
  RESULTS
  Histopathological findings revealed a well-differentiated squamous cell carcinoma overlying an area of necrobiosis lipoidica. Treatment was by excision and split-thickness skin graft.
  
  
  CONCLUSIONS
  Clinicians should be aware of malignant transformation within a plaque of necrobiosis lipoidica. Early detection will allow conservative treatment.
authors.affiliation: Davies Campbell de Lambert, Rhodes, NSW, Australia. shusanlim@gmail.com
authors.forename: Cathy
authors.initials: C
authors.lastname: Lim
authors.forename: Mark
authors.initials: M
authors.lastname: Tschuchnigg
authors.forename: Jake
authors.initials: J
authors.lastname: Lim
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D009335:Necrobiosis Lipoidica / Q000150:complications* / Q000473:pathology; D012878:Skin Neoplasms / Q000209:etiology / Q000473:pathology* / Q000601:surgery