Necrobiosis Lipoidica Diabeticorum (NLD) is a disease of the connective tissue in the skin where the collagen breaks down, the blood vessel walls thicken, and fat deposits build up. More than half of those with necrobiosis lipoidica also have diabetes, and most of them are insulin dependent. NLD occurs among women more than men and is also found among those who have a family history of diabetes or are at risk for developing diabetes.

The cause of NLD is not known, but many correlate it to consistently high blood sugar levels.

What are the symptoms of NLD?

NLD can start as a dull red, raised rash and can eventually evolve into a shiny scar with a violet border and yellow center and blood vessels seen under the skin. These scars can be single lesions or more and are more commonly found on the lower legs, especially the shins. These lesions can also develop on the abdomen, scalp, and arms.

These lesions can be itchy and painful and can crack open, but some people report no symptoms other than the rash. People with NLD can experience periods with no lesions, and periods of flare-ups. These flare-ups seem to occur at random times.

What are the treatments?

It can be difficult to find a treatment that works for NLD. Some people find that cortisone cream applied to the lesions is effective, whereas others get more relief from cortisone injections. Baby aspirin is another common treatment, as are other blood thinners like Trental, which stimulates blood circulation.

In severe cases, prednisone pills (steroids) can be used. If you experience trauma to the affected areas and ulcers form, you should seek immediate attention from your doctor.

Treatment during flare-ups can be tricky, but some find that ultraviolet light treatment works.

How can I prevent it?

Since NLD is suggested to be associated with high blood sugar levels, preventing NLD is best done by maintaining good diabetes care and keeping your blood sugar at optimal levels.

To learn more about skin and diabetes:

6 Skin Conditions Associated with Diabetes
Solutions for Diabetic Itching Problems
Got Sun? Sunlight May Prevent Obesity and Type 2 Diabetes

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