A Case of Ischemic Fasciitis in a Middle-aged Male

Abstract

A 51-year-old male patient experienced repeated periods of prolonged bed rest for approximately one month due to the exacerbation of anxiety neurosis. The symptoms had begun six months prior to his initial visit. Three months before his first visit, the patient became aware of a soft, tender subcutaneous mass in the sacral region, which gradually increased in size. He was referred to our department for further evaluation. MRI revealed a subcutaneous mass on the sacral fascia with low signal intensity on both T1-weighted and T2-weighted images, without any fat-suppressed changes. Histopathological examination following total resection showed a nodule in the deep dermis and subcutis. The nodule contained central necrotic areas with fibrinoid metaplasia and a lack of cellular components, surrounded by granulomatous changes with vascularization, edematous stroma, fibrosis, and cellular pleomorphism. Immunohistochemical staining and special stains showed diffuse positivity for vimentin, partial positivity for alcian blue and α-SMA in some areas, and negativity for S-100 and CD34, leading to a diagnosis of ischemic fasciitis. This condition is most commonly seen inelderly and bedriddenpatien ts ; however, it is rare inhealthy adults. Recently, cases have been reported in younger patients. To diagnose this disease, it is important to inquire about episodes of chronic pressure overload during the patient interview and perform a histopathological examination. Skin Research, 24: 14-19, 2025