Skin Necrosis Caused by Simple Massage Equipment

1 A 11-year-old boy was diagnosed as having ulcerative colitis at the age of 6 years, although his condition was almost cured. We report a rare case of extensive skin necrosis caused by simple massage equipment. The boy massaged his left thigh by using simple massage equipment (Fig. 1) before going to bed. At dawn, he noticed pain in his left thigh and found that a 10-cm portion of skin had turned dark. Therefore, at 9:00 am, he visited a dermatology clinic, where he received ointment treatment. However, the area with an abnormal color tone expanded and became darker, so he visited our hospital’s emergency department and was admitted. The anterolateral skin of his left thigh showed some blisters and a purplish black color within a surface area of 20 × 10 cm. Reminiscent of keloid constitution, posttraumatic and postoperative hypertrophic scars were scattered on the limbs and trunk. The inhalation activated partial thromboplastin time was 48.4 seconds, and the amount of fibrin degradation product was 40.7 μg. Blood tests conducted in the hospital revealed coagulation and fibrinolysis. The affected skin showed necrosis, including fat tissue. We performed debridement of the area 1 month after the injury (Fig. 2). Hematoma spread on the fascia, and obstructed perforating branches of the affected area were observed. The defect was covered with full-thickness skin grafts from the left groin. After more than 9 years, his left leg had fine motor function, and the affected skin was in good condition.