Indicators of necrobiosis lipoidica diabeticorum (NLD) vary widely in patients. The condition usually causes skin lesions to develop on the shins, but lesions can also affect other parts of the legs, arms, hands, trunk, face and scalp. The lesions typically occur on both sides of the body but can also affect just one side.

NLD can spread slowly or rapidly. The patient may feel the need to scratch the sores, but this can cause pain if the sores become opened. The sores may start as one or more small round or oval nodules, often reddish in appearance, which become larger and more irregular lesions. Other common signs and symptoms of NLD include:

• Damage to or wasting of skin
  
  
• Discoloration of the skin. An NLD lesion typically has:
  
  
• A raised border that is purple, dark red or brown
  
  
• A shiny, waxy plaque in the center, made up of fat deposits, that is yellow, yellow-bronze, yellow-pink, orange or, in late stages, brown
  
  
• Destruction of hair follicles
  
  
• Destruction of sebaceous glands, tiny glands in the skin that secrete oil
  
  
• Granulomatous inflammation, containing granular growth (small lumpy lesions)
  
  
• Spider veins (telangiectasia) caused by dilation of small blood vessels underneath the skin’s surface
  
  
• Thickening of the walls of the blood vessels serving the skin