Iron Lady: A Case of Eosinophilic Fasciitis

Diana Valadares, Joao Neves, Isabel Almeida, Carlos Lopes, Carlos Vasconcelos


       Eosinophilic Fasciitis is a rare rheumatologic disease usually characterized by erythema and limbs’ pain, cutaneous induration and peripheral eosinophilia. However, it is important to consider Eosinophilic Fasciitis in differential diagnosis of others scleroderma-like syndromes. The authors present a case of a 52-year-old woman who presented to our hospital with a four months evolution of limb and trunk diffuse symmetrical cutaneous induration, thickening of the skin without joint involvement and no history of Raynaud's phenomenon. On physical examination, she had a grade 3 skin thickening in the involved segments. Laboratory studies revealed no peripheral eosinophilia. The biopsy showed fibrotic involvement of muscle and fascia, with a few inflammatory infiltrations of lymphocytes. She started prednisolone 1 mg/kg/day, with partial regression of cutaneous injuries. As Eosinophilic Fasciitis is so rare, its recognition can be difficult, especially when the patient is observed at a late stage where the peripheral eosinophilia and inflammatory infiltration in the histology are usually no longer present. A clinical history and a detailed physical examination, especially with the presence of orange peel skin, are the fundamental clues for the diagnosis.



Eosinophilia Fasciitis; Cutaneous induration; Eosinophilia; Steroids

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Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.     
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