What are the other Names for this Condition? (Also known as/Synonyms)

• Atypical Decubital Fibroplasia
• Decubital Ischemic Fasciitis
• Ischaemic Fasciitis

What is Ischemic Fasciitis? (Definition/Background Information)

• Ischemic Fasciitis is a benign mass that generally forms deep in the subcutaneous tissue following a lack of sufficient blood supply to the region
• It is termed as a ‘pseudosarcoma’ due to a proliferation of fibroblasts and myofibroblasts (certain cell types) in the body
• Ischemic Fasciitis has no well-established cause or risk factor; however, it is seen against a background of physical immobilization or confinement for a prolonged duration of time
• In many cases, the limb girdle or spine bottom is affected. Even though it can cause swelling at the site, no pain is generally noted
• A complete surgical removal of Ischemic Fasciitis results in a cure and is the treatment of choice. A recurrence of the tumor is uncommon; it can only form when the underlying cause is not addressed suitably
• Typically, the prognosis of Ischemic Fasciitis is good on suitable surgical treatment, since it is a benign condition

Who gets Ischemic Fasciitis? (Age and Sex Distribution)

• Ischemic Fasciitis is mostly seen in older adults (60-90 years); however, it may affect individuals of any age group
• Individuals of both genders (males and females) are affected, though there is a slight male predominance. Some studies show a slight female preference
• Ischemic Fasciitis is seen to affect all races and ethnic groups

What are the Risk Factors for Ischemic Fasciitis? (Predisposing Factors)

The risk factors for Ischemic Fasciitis are unknown in many cases. It may occur in some cases due to the following factors:

• Due to an absence of movement, such as due to physical immobility
• Any condition that leads to prolonged bed rest or confinement
• Some individuals with Ischemic Fasciitis are known to be feeble and weak (debilitated), placing them at an increased risk
• Ischemia or lack of proper blood supply to the region, which occurs due to constant pressure or an injury may result in the formation of the tumor

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Ischemic Fasciitis? (Etiology)

Ischemic Fasciitis is a benign tumor of unknown cause.

• In many cases, a history of trauma that occurs due to immobility or constant pressure is thought to trigger the condition
• This can cause a constant lack of adequate blood supply to the region (called ischemia), which can result in the breakdown or degeneration of tissue
• Over time, the repair and regenerative process is believed to give rise to an Ischemic Fasciitis

What are the Signs and Symptoms of Ischemic Fasciitis?

The signs and symptoms of Ischemic Fasciitis include:

• A solitary mass that forms in deep subcutaneous tissue; it can infiltrate into adjoining tissues and even the deep muscles
• The size of the mass is 4-7 cm on an average
• Swelling and tenderness at the site
• Absence of pain
• Site of frequent involvement is the shoulder girdle or limb girdle, the spine bottom (sacrum), and proximal end of the femur (greater trochanter)
• Sometimes, the chest wall and back can also be involved

How is Ischemic Fasciitis Diagnosed?

Ischemic Fasciitis diagnosis may involve the following tests and exams:

• Physical examination and evaluation of medical history
• Radiological studies of the affected region, such as using MRI and CT scans
• Tissue biopsy of tumor specimen: A tissue biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: Under a microscope, the tumor may resemble a proliferative fasciitis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Ischemic Fasciitis?

In some cases, the complications from Ischemic Fasciitis could include:

• Secondary infections of bacteria and fungus that may affect the region
• Sepsis: It is a life-threatening complication due to blood infection

How is Ischemic Fasciitis Treated?

• The treatment of Ischemic Fasciitis is a simple excision and removal of the tumor, which can result in a cure. This is the preferred treatment in many cases
• Follow-up care and regular healthcare visits are necessary

How can Ischemic Fasciitis be Prevented?

Currently, Ischemic Fasciitis is a condition that is generally not preventable. However, the following factors may be considered to reduce its risk:

• For individuals who are confined to their beds or wheelchairs, it is important that the attending caretakers change their positions regularly. Constantly altering position limits the amount of constant pressure or friction in an area of skin over a long time
• Since, a contributing factor to Ischemic Fasciitis is severely limited mobility, a regimen of daily exercise can help maintain the body and improve blood flow

What is the Prognosis of Ischemic Fasciitis? (Outcomes/Resolutions)

• The prognosis of Ischemic Fasciitis is generally good after a local excisional surgery to remove the benign mass
• There is no recurrence risk following tumor removal, even if the tumor is not removed completely
• But if the reason for formation of Ischemic Fasciitis is not addressed completely (such as prolonged physical immobility or being confined to a bed), then the tumor may form again
• The prognosis is also linked to the severity of the underlying condition and health status of the individual

Additional and Relevant Useful Information for Ischemic Fasciitis:

• A pressure sore (or bed sore) is caused by constant rubbing or pressing against a certain area of skin resulting in its breakdown, due to reduced blood flow. It can occur from remaining in the same position, such as being bedridden, for a prolonged duration of time

The following link may help you understand pressure sores:

http://www.dovemed.com/diseases-conditions/pressure-sores/