Case Of Eosinophilic Fasciitis Research Articles

A case of eosinophilic fasciitis without skin manifestations: a case report in a patient with lupus and literature review

Eosinophilic fasciitis (EF) is a rare connective tissue disease that causes inflammation and fibrosis of the fascia, inducing pain and motor dysfunction. Characteristic skin manifestations, such as edema, erythema, induration, peau d'orange appearance, and the groove sign, are of diagnostic significance and observed in the majority of patients with EF. We herein report a case of EF without these characteristic skin manifestations. A 66-year-old Japanese woman developed progressive limb pain and motor dysfunction. No skin changes were observed. We diagnosed the patient with EF based on the clinical course, magnetic resonance imaging, and en bloc biopsy containing fascia and muscle. Oral prednisolone therapy markedly attenuated limb pain and motor dysfunctions. Through a systemic search of the medical literature, we retrieved 4 juvenile cases and 8 adult cases of EF without characteristic skin manifestations during the clinical course. We herein present a systemic review on EF without skin manifestations and discuss differences between the two proposed sets of diagnostic criteria of EF.

Case of eosinophilic fasciitis during military training in a Nepalese British infantry soldier

We present the case of a Nepalese British soldier with peripheral oedema and a significantly raised eosinophil count. After extensive investigation looking for a parasitic cause of his illness, he...

A case of eosinophilic fasciitis and generalized morphea overlap

A 60-year old man developed skin hardening and edema on his extremities. Although he had been treated with oral prednisolone at another hospital, skin stiffness relapsed during tapering of prednisolone. At the initial visit to our department, physical examination showed skin hardening of the extremities and also symmetric erythematous macules on the back. Histological examination revealed fasciitis on the forearm and morphea on the back. Eosinophilic fasciitis is occasionally associated with morphea. However, cases of concurrent eosinophilic fasciitis and generalized morphea are rare. In the present case, CD34 was differentially expressed in both lesions, suggesting eosinophilic fasciitis and morphea are separate diseases with different origin of mesenchymal cells.

Eosinophilic Fasciitis Following Checkpoint Inhibitor Therapy: Four Cases and a Review of Literature.

Checkpoint inhibitor therapy is widely known to cause a number of immune-related adverse events. One rare adverse effect that is emerging is eosinophilic fasciitis, a fibrosing disorder causing inflammatory infiltration of subcutaneous fascia. It is characterized clinically by edema and subsequent induration and tightening of the skin and subcutaneous tissues. The condition is rare, yet at our institutions we have seen four cases in the past 3 years. We describe our 4 cases and review 11 other cases reported in the literature. We present four cases of eosinophilic fasciitis following treatment with programmed cell death protein 1 or programmed cell death-ligand 1 blockade. All patients had extremity involvement with characteristic skin changes ranging from peripheral edema to induration, tightening, and joint limitation. The patients had varying degrees of peripheral eosinophilia. In two of our patients, the diagnosis was made by full-thickness skin biopsy showing lymphocytic infiltration of the subcutaneous fascia, with CD4+ T cells predominating in one case and CD8+ T cells in the other. In the other two cases, the diagnosis was made on the basis of characteristic imaging findings in the context of clinical features consistent with the diagnosis. All four patients were treated with glucocorticoids with varying degrees of success; immunotherapy had to be discontinued in all four. Patients with advanced melanoma who experienced this adverse effect had either a partial response or a complete response to therapy. Eosinophilic fasciitis can occur as a result of checkpoint inhibitor therapy. Although a tissue diagnosis is the gold standard, imaging studies may facilitate the diagnosis in the presence of consistent clinical features, but a degree of suspicion is key to recognizing the condition early. Therapy requires a collaborative approach by oncology, rheumatology, and dermatology; physical therapy is an important adjunct in treatment. For advanced melanoma, it may be a good prognostic indicator. It is important for clinicians to recognize that eosinophilic fasciitis is a potential immune-related adverse event (irAE) as a consequence of immune checkpoint inhibitor therapy. The presentation is quite stereotypical; the diagnosis can be made by imaging in the absence of a full-thickness skin biopsy. Early intervention is important to limit morbidity. This irAE may be a good prognostic sign among patients with melanoma.

Drastic skin change: A case of eosinophilic fasciitis associated with peripheral T-cell lymphoma

Drastic skin change: A case of eosinophilic fasciitis associated with peripheral T-cell lymphoma

A Case of Eosinophilic Fasciitis: Imaging Findings from Early Diagnosis to Complete Remission

A Case of Eosinophilic Fasciitis: Imaging Findings from Early Diagnosis to Complete Remission

Erster Nachweis von Sarcocystis hjorti bei der Fleischuntersuchung von Rothirschen in der Schweiz

In meat samples from 2 hunted red deer (Cervus elaphus) of different origins (region Ilanz, region Filisur) large-scale greenish tissue discolorations with a gelatinous change of fascia were observed and diagnosed as eosinophilic fasciitis. Sarcocystis hjorti, a recently described Sarcocystis species in red deer and moose in Norway, was found as the causing agent. Foxes are regarded as final hosts in the development cycle of this parasite. Factors leading to such cases of eosinophilic fasciitis due to sarcosporidiosis, which is widespread in farm and wild ruminants and is normally inapparent are largely unknown. According to meat inspection directives carcasses with such discolorations have to be declared unfit for human consumption.

Eosinophilic Fasciitis: A Rare Skin Sclerosis

Eosinophilic fasciitis (Schulman's syndrome) is a rare disease with specific clinical symptoms such as the groove sign which facilitate diagnosis. We report a typical case of eosinophilic fasciitis in an otherwise healthy 49-year-old man who presented with “prayer and groove signs”. Histological analysis showed sclerosis and eosinophilic infiltration of the fascia. The patient was successfully treated with systemic corticotherapy and Cyclosporine. A short review of the clinicopathological features of the lesions is presented.

A Case of Eosinophilic Fasciitis with Hair Loss

A Case of Eosinophilic Fasciitis with Hair Loss

Long-term remission by cyclosporine in a patient with eosinophilic fasciitis associated with primary biliary cirrhosis

A 70-year-old man was admitted to the hospital in June 1994 because of cutaneous induration of the extremities. Eosinophilic fasciitis was diagnosed on the basis of the course and distribution of the cutaneous lesions. Cyclosporine (100 mg/day) was given. After 4 weeks of treatment, cutaneous induration and limited joint mobility improved. Liver dysfunction had been diagnosed 5 years before the onset of eosinophilic fasciitis. Primary biliary cirrhosis (PBC) was diagnosed on the basis of the elevated serum biliary-enzyme levels, strongly positive antimitochondrial antibody titer, and histologic features of the liver-biopsy specimens showed stage-3 PBC. These findings suggested that eosinophilic fasciitis developed in association with PBC. PBC is often accompanied by autoimmune diseases, such as Sjögren's syndrome and Hashimoto's disease. To our knowledge, eosinophilic fasciitis associated with PBC has not been reported previously. We believe this is the first time a case of eosinophilic fasciitis occurring in a patient with PBC is documented.

Miliary Tuberculosis in a Patient With Eosinophilic Fasciitis

The fibrosing disorders represent a diverse group of uncommon chronic diseases that include systemic sclerosis, eosinophilic fasciitis, eosinophilia-myalgia syndrome, toxic oil syndrome, and localized forms of fibrosis. A rare case of eosinophilic fasciitis is reported. The patient was a 61-year-old female who presented with generalized massive edema and eosinophilia. Signs of common edema-producing diseases, such as heart failure, were absent. Corticosteroids were initiated with slow improvement in edema. Over the ensuing months, miliary tuberculosis and tenosynovitis of her left hand and left foot developed, which responded to appropriate treatment. Moreover, prominent induration, hyperpigmentation, and coarse puckering of the skin gradually took place. Other conditions, especially neoplasms and infections, have been described in association with eosinophilic fasciitis, but this is the first reported case of miliary tuberculosis associated with the disease.

A case of eosinophilic fasciitis with change of serum Th1/Th2 cytokine level which correlated with disease activity.

A 25-year-old female who had right knee and ankle joint swelling with arthralgia in July 1999, was diagnosed as having eosinophilic fasciitis (EF) based on typical skin sign and the result of muscle biopsy. Treatment was started with 20 mg of oral prednisolone per day. Her symptoms had subsided but they later recurred as the prednisolone dose was gradually tapered. We measured her serum cytokine levels during the course. Her serum IFN-gamma increased and IL-4 decreased after the treatment compared with those levels prior to treatment. And the cytokine levels reverted to pre-treatment status when she had a relapse. The cytokine balance seems to play some role in the etiology of EF.

Progressive swelling and stiffness of the extremities: another case of eosinophilic fasciitis

Progressive swelling and stiffness of the extremities: another case of eosinophilic fasciitis

A case of eosinophilic fasciitis which can only be treated by cyclosporin-A

A case of eosinophilic fasciitis which can only be treated by cyclosporin-A

La fasciite de Shulmann est-elle une maladie autoimmune? A propos d'une observation

The authors report a case of eosinophilic fasciitis associated with several autoimmune diseases, such a Graves' disease, pernicious anaemia and vitilgo. These associations suggest an autoimmune etiology for the eosinophilic fasciitis.

Fasciites de shulman: 3 observations

We describe three cases of eosinophilic fasciitis, two women and one man who presented with edematous syndrome and hypereosinophilia. A parasitologic disease was first suspected, emphasizing the diagnosis difficulties.

Association cirrhose biliaire primitive — fasciite avec éosinophilie

We describe a case of eosinophilic fasciitis with clinical and histological characteristic features occuring in a 51-old male patient with primary biliary cirrhosis (PBC) proved by positivity of antimitochondrial antibodies and liver biopsy. If association of PBC with scleroderma is well documented, it was never reported with eosinophilic fasciitis.

Eosinophilic Fasciitis Associated With Tryptophan Ingestion

Recently, the ingestion of tryptophan has been associated with eosinophilia-myalgia syndrome, which is characterized by eosinophilia, myalgias, and several less consistently reported findings. We treated 13 patients who exhibited clinical features of eosinophilic fasciitis who were taking high-dose tryptophan before the onset of clinical symptoms. Twelve patients exhibited eosinophilia, with eosinophil counts ranging from 0.13 to 0.88. The remaining patient was taking oral corticosteroids when her eosinophil count was determined. Eight patients complained of myalgias. Other symptoms included arthralgias, pruritus, cutaneous burning, weakness, fever, rashes, malaise, edema, muscle spasms, and alopecia. 5-Hydroxyindoleacetic acid levels were elevated in four of the eight urine specimens that were tested. Our findings suggest that previously diagnosed cases of eosinophilic fasciitis may represent variants of tryptophan-associated eosinophilia-myalgia syndrome. Derangements in the metabolism of tryptophan may play a role in sclerotic diseases.

EOSINOPHILIC FASCIITIS ASSOCIATED WITH INFLAMMATORY NEUTROPHILIC VASCULITIS

The authors report a case of eosinophilic fasciitis with an histopathological pattern of inflammatory neutrophilic vasculitis associated with the typical inflammatory infiltrate. The presence of this type of vasculitis which may be observed in the initial forms of scleroderma supports the hypothesis of a considerable overlap between these two entities.

Eosinophilic fasciitis during pregnancy

The first reported case of eosinophilic fasciitis developing in pregnancy is discussed, and the obstetric management is reported. Eosinophilic fasciitis is a rare disease characterized by pain, swelling, and tenderness over the extremities, followed by induration of the skin. Laboratory findings include peripheral eosinophilia, hypergammaglobulinemia, an elevated erythrocyte sedimentation rate, distinctive histopathologic changes, and scleroderma-like skin induration without rheumatoid serologic markers. Diagnosis is made by biopsy of the deep fascia of the affected area. The deep fascia will be infiltrated with plasma cells, lymphocytes, and eosinophils. Prednisone is the therapy of choice. Carpal tunnel syndrome and rare serious hematologic abnormalities have been associated with eosinophilic fasciitis.