{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:18:17Z","timestamp":1783012697555,"version":"3.54.6"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Necrobiosis lipoidica (NL) is a rare chronic granulomatous skin disorder most commonly associated with diabetes mellitus, typically presenting in middle-aged women. We report an unusual case of NL in a young, non-diabetic male following orthopedic surgery involving a metallic implant. The patient developed characteristic well demarcated, atrophic, violaceous-brown plaques with violaceous borders localized over shin area of his left lower leg. Histopathological examination confirmed the diagnosis of NL, showing palisading granulomas with necrobiosis and lipid-laden macrophages. Notably, there was no history of diabetes, hypothyroidism, glucose intolerance, or autoimmune disease. This case highlights a rare presentation of NL potentially triggered by local immune dysregulation by trauma, surgery and the presence of a metallic implant. The report underscores the importance of considering NL in the differential diagnosis of persistent postsurgical cutaneous lesions, even in non-diabetic individuals, and raises questions about trauma, implant-related immune dysregulation, or microvascular changes as possible pathophysiological mechanisms.<\/jats:p>","DOI":"10.4103\/npmj.npmj_104_26","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:00:16Z","timestamp":1782968416000},"page":"546-549","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Orthopaedic Implant Surgery or Trauma as a Trigger for Necrobiosis Lipoidica: A Manifestation of an Immunocompromised Cutaneous District?"],"prefix":"10.4103","volume":"33","author":[{"given":"Praneet","family":"Awake","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Symbiosis Medical College for Women and Symbiosis University Hospital and Research Centre, Symbiosis International (Deemed University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laxman","family":"Salwe","sequence":"additional","affiliation":[{"name":"Twacha Clinic, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Dongre","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"R1-20260702","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1111\/j.1468-3083.2009.03345.x","article-title":"The immunocompromised district: A unifying concept for lymphoedematous, herpes-infected and otherwise damaged sites","volume":"23","author":"Ruocco","year":"2009","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R2-20260702","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.jaad.2013.05.034","article-title":"Update on necrobiosis lipoidica: A review of etiology, diagnosis, and treatment options","volume":"69","author":"Reid","year":"2013","journal-title":"J Am Acad Dermatol"},{"key":"R3-20260702","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1684\/ejd.2012.1839","article-title":"Update on clinical and laboratory features in necrobiosis lipoidica: A retrospective multicentre study of 52 patients","volume":"22","author":"Erfurt-Berge","year":"2012","journal-title":"Eur J Dermatol"},{"key":"R4-20260702","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13256-022-03698-9","article-title":"Necrobiosis lipoidica of the breast associated with Crohn's disease: A case report","volume":"17","author":"Kelati","year":"2023","journal-title":"J Med Case Rep"},{"key":"R5-20260702","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.annder.2023.03.005","article-title":"Post-traumatic ulcerated and chronic necrobiosis lipoidica of the elbow: A new entity?","volume":"150","author":"Elzaouk","year":"2023","journal-title":"Ann Dermatol Venereol"},{"key":"R6-20260702","doi-asserted-by":"crossref","first-page":"e3788","DOI":"10.1097\/GOX.0000000000003788","article-title":"Necrobiosis lipoidica following breast reduction","volume":"9","author":"Absil","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R7-20260702","doi-asserted-by":"crossref","first-page":"233","DOI":"10.4103\/0378-6323.197389","article-title":"Necrobiosis lipoidica developing within a surgical scar in a non-diabetic patient: Type III Koebner phenomenon (isomorphic response), Wolf's isotopic response or Ruocco's immunocompromised cutaneous district?","volume":"83","author":"Prieto-Torres","year":"2017","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R8-20260702","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/S0001-7310(06)73349-X","article-title":"Necrobiosis lipoidica over appendectomy scar in a patient with morphea of the breast","volume":"97","author":"Acebo","year":"2006","journal-title":"Actas Dermosifiliogr"},{"key":"R9-20260702","first-page":"55","article-title":"Necrobiosis lipoidica and silicotic granulomas on Muller's phlebectomy scars","volume":"194","author":"Vion","year":"1997","journal-title":"Dermatology"}],"container-title":["Nigerian Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/npmj.npmj_104_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:31:56Z","timestamp":1783009916000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/npmj.npmj_104_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/npmj.npmj_104_26","relation":{},"ISSN":["1117-1936","2468-6875"],"issn-type":[{"value":"1117-1936","type":"print"},{"value":"2468-6875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}