Necrobiosis lipoidica diabeticorum is a granulomatous skin disease of uncertain pathogenesis. Many therapeutic approaches have been reported in the literature, but none of them can be considered the gold standard.
Fractional CO2 laser treatment shows peculiar effects in the skin, mainly due to its ability of modulating cytokine pathways of tissue-repairing mechanisms. Thus, we propose fractional CO2 laser in the management of refractory necrobiosis lipoidica in selected recalcitrant patients.