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Eosinophilic fasciitis

Eosinophilic fasciitis
Classification and external resources
ICD-10 M35.4
ICD-9-CM 728.89
OMIM 226350
DiseasesDB 29427
MedlinePlus 000447
eMedicine med/686

Eosinophilic fasciitis , also known as "Shulman's syndrome",[1] is a form of fasciitis, the inflammatory diseases that affect the fascia, the connective tissues surrounding muscles, blood vessels and nerves. Unlike other diseases in that category, it is limited to the arms and legs, and usually resolves itself, although some cases require corticosteroids, and some cases are associated with aplastic anemia.[2]

The presentation of eosinophilic fasciitis is similar to scleroderma or systemic sclerosis. However, unlike scleroderma, it affects the fascia, not the skin (dermis). The characteristic and severe effects of scleroderma and systemic sclerosis, such as Raynaud's syndrome, involvement of the extremities, prominent small blood vessels (telangiectasia), and visceral changes such as swallowing problems, are absent.

It was first characterized in 1974,[3] and it is not yet known whether it is actually a distinct condition or just a different presentation. However, it remains used for diagnostic purposes.

Several cases have been reported after strenuous exercise.


  • Symptoms 1
  • Treatment 2
  • Diagnosis 3
  • Epidemiology 4
  • See also 5
  • References 6
  • Further reading 7
  • External links 8


As it is a rare disease, a clear set of symptoms is difficult to define. Usually, patients show severe pain and swelling is reported but clinical presentations vary. It can have an 'orange peel' like appearance.[4] Less common features are joint pain and carpal tunnel syndrome.


Common treatments include corticosteroids[5] such as prednisone, though other medications such as hydroxychloroquine[6] have also been used. The prognosis is usually good in the case of an early treatment if there is no visceral involvement.[4][7]


The key to diagnosis is skin changes combined with blood eosinophilia but the most accurate test is a skin, fascia and muscle biopsy.


Typical age of onset is around 40 to 50 years. It is not clear whether it is more common in women than men - patient numbers are small and some studies report a preponderance of men and others women.[8] It is also found in children.

See also


  1. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby.  
  2. ^ Merck Manual, Professional Edition, Eosinophilic Fasciitis
  3. ^ Shulman LE (1975). "Diffuse fasciitis with eosinophilia: a new syndrome?". Trans. Assoc. Am. Physicians 88: 70–86.  
  4. ^ a b Bischoff, Lindsay; Chris T. Derk (January 2008). "Eosinophilic fasciitis: demographics, disease pattern and response to treatment: report of 12 cases and review of the literature". International Journal of Dermatology 47 (1): 29–35.  
  5. ^ Antic M, Lautenschlager S, Itin PH (2006). "Eosinophilic fasciitis 30 years after - what do we really know? Report of 11 patients and review of the literature". Dermatology (Basel) 213 (2): 93–101.  
  6. ^ Lakhanpal S, Ginsburg WW, Michet CJ, Doyle JA, Moore SB (1988). "Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases". Semin. Arthritis Rheum. 17 (4): 221–31.  
  7. ^ Valadares, Diana; Joao Neves; Isabel Almeida; Carlos Lopes; Carlos Vasconcelos (February 2011). "Iron Lady: A Case of Eosinophilic Fasciitis". Journal of Medical Case Reports 2: 34–36.  
  8. ^ Wojas-Pelc A, Wielowieyska-Szybińska D, Lipko-Godlewska S (2004). "[Eosinophilic fasciitis--current database]". Pol. Merkur. Lekarski (in Polish) 16 (96): 585–8.  

Further reading

  • Lakhanpal, Sharad; Ginsburg, William W.; Michet, Clement J.; Doyle, John A.; Moore, S.Breanndan (1988). "Eosinophilic fasciitis: Clinical spectrum and therapeutic response in 52 cases". Seminars in Arthritis and Rheumatism 17 (4): 221–231.  
  • Barnes L, Rodnan GP, Medsger TA, Short D (August 1979). "Eosinophilic fasciitis. A pathologic study of twenty cases".  
  • Doyle JA, Ginsburg WW (September 1989). "Eosinophilic fasciitis".  
  • Michet CJ, Doyle JA, Ginsburg WW (January 1981). "Eosinophilic fasciitis: report of 15 cases".  
  • Bennett, R M; Herron, A; Keogh, L (1977). "Eosinophilic fasciitis. Case report and review of the literature.". Annals of the Rheumatic Diseases 36 (4): 354–359.  
  • Falanga, Vincent; Medsger, Thomas A. (1987). "Frequency, levels, and significance of blood eosinophilia in systemic sclerosis, localized scleroderma, and eosinophilic fasciitis". Journal of the American Academy of Dermatology 17 (4): 648–656.  
  • Varga J, Kähäri VM (November 1997). "Eosinophilia-myalgia syndrome, eosinophilic fasciitis, and related fibrosing disorders".  
  • Kent, Lawrence T.; Cramer, Stewart F.; Moskowitz, Roland W. (1981). "Eosinophilic fasciitis". Arthritis & Rheumatism 24 (5): 677–683.  
  • Moulton SJ, Kransdorf MJ, Ginsburg WW, Abril A, Persellin S (March 2005). "Eosinophilic fasciitis: spectrum of MRI findings".  

External links

  • Merck Manual, Professional Edition, Eosinophilic Fasciitis
  • DermAtlas 1973850164
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