Necrobiosis lipoidica is a necrotising skin condition that usually occurs in patients with diabetes mellitus but can also be associated with rheumatoid arthritis. In the former case it may be called necrobiosis lipoidica diabeticorum (NLD). NLD occurs in approximately 0.3% of the diabetic population, with the majority of those affected are women (approximately 3:1 females to males affected). The severity or control of diabetes in an individual does not affect who will or will not get NLD. Better maintenance of diabetes after being diagnosed with NLD will not change how quickly the NLD will resolve. Signs and symptoms
NL/NLD most frequently appears on the patients shins, often on both legs, although it may also occur on forearms, hands, trunk, and, rarely, nipple, penis, and surgical sites. The lesions are often asymptomatic but may become tender and ulcerate when injured. The first symptom of NL is often a "bruised" appearance (erythema) that is not necessarily associated with a known injury. The extent to which NL is inherited is unknown. NLD appears as a hardened, raised area of the skin. The center of the affected area usually has a yellowish tint while the area surrounding it is a dark pink. It is possible for the affected area to spread or turn into an open sore. When this happens the patient is at greater risk of developing ulcers. If an injury to the skin occurs on the affected area, it may not heal properly or it will leave a dark scar.
Triangular alopecia  is hair loss that may be congenital but usually appears in childhood as a focal patch of loss that may be complete or leaving fine vellus hairs behind. : 643  Affected individuals are typically entirely healthy. Hair restoration surgery using follicular unit transplantation has been a successful treatment modality for TTA

Presentation
Association with Other Conditions
TTA has been associated with several disorders, such as Phakomatosis pigmentovascularis. And a rare syndrome Setleis syndrome. It is inherited by the autosomal dominant trait and is characterized by cutis aplasia or atrophic skin at the temples, which is said to resemble forceps marks. There may also be a coarse facial appearance, anomalies of the eyelashes and eyebrows, and periorbital puffiness. Frequency
The suggested frequency for this condition in the general population is around 0.11%. The hair loss is non-progressive and does not expand beyond these areas. It is a non-inflammatory, non-scarring form of hair loss easily confused with alopecia areata. In one report, the condition was incorrectly believed by the parents to be induced by doctors inserting intravenous cannulas into scalp vessels during the neonatal period. The condition is permanent and the affected skin does not change later in life.Of the 53 reported cases of TTA, more than half (55.8%) were detected in childhood between the ages of 2 and 9 years, while 36.5% were detected at birth and only 3.8% (only two cases) in adulthood. See also
Alopecia
Skin lesion
List of cutaneous conditions


== References ==