title: [Dual localisation of ischaemic fasciitis with local relapse at one site].
abstract: BACKGROUND
  Ischaemic fasciitis (IF) is a rare pseudosarcomatous proliferation initially described on the pressure points of long-term bedridden patients. Healing is the rule after surgical excision. No multifocal localisations have been reported to date. Herein, we describe the case of a patient with FI affecting two sites and having recurred at one of them.
  
  
  METHODS
  A 50-year-old woman with scoliosis and mental retardation consulted for a hard skin lesion next to her right scapula. Elastofibroma was diagnosed on the basis of a surgical biopsy sample. Early local recurrence led to a second resection four months later. Histologically, central fibrinoid necrosis was observed, surrounded by collagenous tissue containing occasionally atypical fibroblasts and numerous capillaries. The diagnosis of ischaemic fasciitis was made by a national expert. Six months later, we observed a 13-cm purplish erythematous infiltrated mass with a 6-cm ulceration at the surgical site. A second 6-cm non-ulcerated indurated purplish lesion was visible next to the right greater trochanter. The scan showed deep soft-tissue infiltration with subfascial extension and contact with the greater trochanter. Superficial biopsies of both lesions showed only an appearance of granulation tissue. MRI performed after five months showed an extension of lesions at the two sites with an appearance evocative of ischaemic fasciitis. Surgical excision was refused by the patient and her family.
  
  
  CONCLUSIONS
  We report a rare case of ischaemic fasciitis at two separate sites with local relapse after surgical excision.
authors.affiliation: Service de dermatologie, CHRU de Tours, 37044 Tours cedex 09, France; Service d'anatomie pathologique, CHRU de Tours, 37044 Tours cedex 09, France. Electronic address: thibault.kervarrec@etu.univ-tours.fr.
authors.forename: T
authors.initials: T
authors.lastname: Kervarrec
authors.affiliation: Service de dermatologie, CHRU de Tours, 37044 Tours cedex 09, France.
authors.forename: L
authors.initials: L
authors.lastname: Lagier
authors.affiliation: Service d'anatomie pathologique, CHRU de Tours, 37044 Tours cedex 09, France.
authors.forename: M-C
authors.initials: MC
authors.lastname: Machet
authors.affiliation: Service de dermatologie, CHRU de Tours, 37044 Tours cedex 09, France; Faculté de médecine de Tours, 10, boulevard Tonnellé, 37032 Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Machet
mesh_terms: D001415:Back; D001706:Biopsy; D002196:Capillaries; D005208:Fasciitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005347:Fibroblasts / Q000473:pathology; D005350:Fibroma / Q000473:pathology / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012008:Recurrence; D012540:Scapula; D012871:Skin Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
keywords: Atypical decubital fibroplasia; Fasciite ischémique; Fibroplasie atypique de décubitus; Ischaemic fasciitis; Prolifération pseudo-sarcomateuse; Pseudosarcomatous proliferation; Recurrence; Récidive