Necrobiosis lipoidica (NL) is a rare chronic inflammatory granulomatous skin disease, often associated with diabetes mellitus. We present the case of a 52-year-old Filipino female with a history of hypertension and well-controlled diabetes, who developed an ulcerated lesion on her right leg following an insect bite. Despite various self-medications and multiple treatments from different physicians, the ulcer persisted and progressed, leading to her referral for further evaluation. Histopathologic examination confirmed necrobiosis lipoidica. Initial treatment with topical corticosteroids and tacrolimus showed minimal improvement, prompting the use of punch grafting and platelet-rich plasma (PRP) injections. After six PRP sessions, the patient exhibited significant wound healing and a notable reduction in pain, leading to an improved quality of life. This case highlights the effectiveness of punch grafting and PRP injections in managing ulcerated NL, providing a novel therapeutic approach for a challenging condition.