What Is Necrobiosis Lipoidica Diabeticorum?

A skin condition called necrobiosis lipoidica diabeticorum (NLD) occurs when collagen breaks down, deposits of fat build up and the blood vessel walls thicken.

As a chronic condition, NLD might progress slowly and might sometimes scar the skin. The condition might not bother you for a while, and other times it might flare up.

What Causes Necrobiosis Lipoidica Diabeticorum?
Researchers do not know the exact cause of necrobiosis lipoidica diabeticorum. However, some studies indicate a possible connection between NLD and damage to small blood vessels that might result from diabetes.

Other theories point to possible causes such as inflamed blood vessels, antibodies or metabolic changes.

What Are the Symptoms of Necrobiosis Lipoidica Diabeticorum?
NLD appears as a rash most often on the lower legs, but some people might notice it on their face, torso, scalp or arms.

In the beginning, the rash might appear reddish-brown with fairly well-defined borders. Over time, the lesions might grow larger and turn shiny and red, sometimes developing a yellow center. Eventually, the lesion develops into a purplish depression in the skin.

Sometimes, NLD itches and hurts; but many people report no symptoms other than the rash.

How Can You Treat Necrobiosis Lipoidica Diabeticorum?
As long as the lesions of the rash do not break open, NLD does not usually require treatment. Your doctor might ask you to rest your legs occasionally and protect them with elastic support stockings. He or she might also recommend that you take a baby aspirin each day.

Treating NLD can be tricky. During a flare up, some people find relief using a topical cream that contains cortisone and covering the area with a sterile dressing. Others find that cortisone injections can help.

Some researchers have found that treating the area with ultraviolet light can control NLD during flare-ups. In some cases, doctors might prescribe steroids such as prednisone.

Trauma to the affected area might cause ulcers to form, and these do need treatment. If this occurs, see your doctor.

How Can You Prevent Necrobiosis Lipoidica Diabeticorum?
Since people with diabetes face a greater chance of developing NLD than those without diabetes, it makes sense to control your disease. To do this, keep your blood sugar levels within the range recommended by your doctor.

Reviewed by Clara Schneider MS, RD, RN, CDE, LDN - 05/13