Eosinophilic Fasciitis: A Scleroderma-like Illness

Abstract

To the Editor.— Shulman 1 recently described two patients with scleroderma-like illnesses characterized by subcutaneous induration of the extremities, eosinophilia, hypergammaglobulinemia, and absence of visceral disease. Biopsy specimens showed fascial thickening and mononuclear cell infiltration between tela subcutanea and muscle; the skin was normal. The appearance of 15 additional cases, 2-5 occasionally with prominent eosinophilic connective tissue infiltration, has justified consideration of a new entity: eosinophilic fasciitis (Shulman syndrome). A patient with the typical clinical and histopathologic features of eosinophilic fasciitis is reported. Report of a Case.— AA 36-year-old male physician sought medical attention in April 1976, for possible scleroderma. Previously healthy and enjoying daily vigorous exercises and jogging, he first noted the onset of hand paresthesiae in January 1976. Digital stiffness and progressive subcutaneous induration of the hands and distal forearms ensued shortly thereafter. Over the next month, induration involving the upper arms and anterior neck was noted. Preceding