One clinical trial, which tested the use of aspirin therapy, reported negative results.5 First-line therapy for NLD includes nonsteroidal inflammatory agents, cryotherapy, and potent topical glucocorticoid agents for early lesions and intralesional corticosteroids injected into the active borders of established lesions. Systemic glucocorticoid therapy may also be effective but can be associated with adverse effects in patients with diabetes. Other therapies for NLD are used in an attempt to decrease the microangiopathy and vascular thrombosis by increasing fibrinolysis or decreasing platelet aggregation and thromboxane A2 synthesis. Anecdotal reports include uncontrolled NLD case series mention stanozolol, inositol niacinate, nicofuranose, ticlopidine hydrochloride, pentoxifylline, retinoids, cyclosporin, chloroquine, fumaric esters, psoralen plus UV-A, and allopurinol as treatment options2- 4,6,7; however, these treatments are only marginally effective in most patients. No major randomized controlled trials are available to identify best clinical practice.