Histological findings (optical microscopy eosin-hematoxilin) of a four-week-old boy with necrotizing fasciitis of the scrotal wall. Ulcerated granulation tissue is shown. The arrow points to absent epidermis, indicating ulceration. Sections of hyper- and parakeratotic scrotal skin gave way to extensive ulceration. The dermis was replaced by remarkably inflamed granulation tissue and essentially comprised only capillaries and pus in many areas. The connective tissue was focally preserved adjacent to these necrotic foci. There was extensive ulceration of the surface also. No granulomas were identified. The appearance was that of necrotizing acute inflammation of the scrotal skin (Fournier gangrene).