Atypical decubital fibroplasia: A series of three cases

Marisa F. Baldassano, Andrew Rosenberg, Thomas J. Flotte

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

We report three cases of atypical decubital fibroplasia (ADF), a benign, reactive pathologic process that develops in the skin and subcutaneous tissue of immobilized or debilitated patients. Two patients were immobilized, one wheelchair bound, and one bedridden. The third patient frequently lay over the affected area. Two were male, one female, ages 49, 66, and 89 (mean 68 years old). Each patient presented with a subcutaneous mass, one with focal surface ulceration, present for 5 months, 6 months, and 12 months (mean 7.7 months). The locations included back, lateral thigh (over greater trochanter), and lateral chest wall. No other lesions were present, and none had recurrences. Histologically, atypical decubital fibroplasia is characterized principally by dermal and subcutaneous tissue involvement with fibrinoid necrosis, reactive fibrosis, and focal myxoid change with surrounding more cellular zones of prominent reactive neovascularization including granulation tissue and ectatic vessels with reactive atypical fibroblasts and fat necrosis. Other findings include hyalinization of vessel walls, fibrin thrombi, red blood cell extravasation, hemosiderin deposition, and acute and chronic inflammation. Although the changes are predominantly deep, involving the dermis, subcutaneous tissue and skeletal muscle, the overlying epidermis may ulcerate. Recognition of atypical decubital fibroplasia is of paramount importance, for it may be misinterpreted as a sarcoma, both clinically and histologically.

Original languageEnglish
Pages (from-to)149-152
Number of pages4
JournalJournal of Cutaneous Pathology
Volume25
Issue number3
DOIs
StatePublished - Apr 2 1998
Externally publishedYes

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Subcutaneous Tissue
Fat Necrosis
Hemosiderin
Skin
Wheelchairs
Granulation Tissue
Thoracic Wall
Pathologic Processes
Dermis
Thigh
Fibrin
Epidermis
Sarcoma
Femur
Skeletal Muscle
Thrombosis
Fibrosis
Necrosis
Fibroblasts
Erythrocytes

ASJC Scopus subject areas

  • Dermatology
  • Pathology and Forensic Medicine

Cite this

Atypical decubital fibroplasia : A series of three cases. / Baldassano, Marisa F.; Rosenberg, Andrew; Flotte, Thomas J.

In: Journal of Cutaneous Pathology, Vol. 25, No. 3, 02.04.1998, p. 149-152.

Research output: Contribution to journalArticle

Baldassano, Marisa F. ; Rosenberg, Andrew ; Flotte, Thomas J. / Atypical decubital fibroplasia : A series of three cases. In: Journal of Cutaneous Pathology. 1998 ; Vol. 25, No. 3. pp. 149-152.
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