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Ischemic Fasciitis : Intro & Clinical Features

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Ischemic fasciitis (aka Atypical Decubital Fibroplasia) is a benign reactive pseudosarcomatous proliferation occurring in soft tissues over bony prominences. It represents exaggerated response to ischemic injury.

Historically, ischemic fasciitis has been considered a lesion of debilitated, elderly, immobilized, bed-ridden, or wheelchair-bound patients with a peak incidence in 8th and 9th decades of life. However, rare cases have been reported in mobile young individuals. Many patients have a history of a chronic disease, malignancy, or trauma.

Patients present with a painless soft tissue mass over bony prominences. The most common locations are shoulder region, chest wall (overlying ribs), sacrococcygeal region, and greater trochanter. This image shows a resection specimen of ischemic fasciitis. It presented as a thoracic mass in a 49 y/o paraplegic male.

Image courtesy of: Rola Ali, MD, FRCPC, Associate Professor of Pathology, Kuwait University, Kuwait; used with permission.

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