In particular, NLD does not presage eye, kidney or vascular problems. Many of the remainder develop diabetes, and NLD should be considered a warning sign of diabetes. Reports vary widely on exactly who is most at risk. Some reports say NLD occurs more often in young women, but some textbooks disagree. The real dangers seem to be ulceration, infection, and the stress from the appearance.
Ulceration sometimes occurs spontaneously, and often as a result of trauma.
Ulceration is often a result of scratching or trauma, and the ulceration from scratching sometimes heals very slowly. Thus avoiding scratching and trauma decreases the amount of ulceration, though some ulceration will occur anyway. No particularly good treatment seems to be known. The ulcerations usually heal if cared for properly, and drastic measures are not called for in most cases. William Biggs reports that skin grafts may be necessary in cases of severe ulceration, but do not tend to give results that are cosmetically attractive.