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Necrobiosis lipoidica diabeticorum (NLD) is present in only 0.3–3% of patients with DM, commonly seen in type 1 DM.[1] Though NLD has been mainly seen in middle ages, it has rarely been described in children.[2] NLD begins as well-circumscribed papule/nodule and progresses over time to form plaque. Initially, it is reddish brown in colour and subsequently with time may turn yellow, with prominent atrophy at the centre of the plaque.[3] The lesions are commonly distributed on the anterior and lateral surfaces of the lower legs; rarely they can affect upper extremities, trunk, face and penis.[1] The pathogenesis of NLD remains unclear. It is thought that children as well as adult diabetic patients with NLD can be at high risk for nephropathy and retinopathy.[3] It is unclear whether strict glycaemic control can improve these lesions. Though spontaneous remission is known, ulceration is the most frequent and hard to treat complication in NLD.[3]

Ancillary