Eosinophilic Fasciitis â€“ Report of Three Cases and Review of the Literature

Uwe Wollina; Gesina Hansel; Jacqueline SchÃ¶nlebe; Birgit Heinig; Ivanka Temelkova; Georgi Tchernev; Aleksandra Vojvodic; Torello Lotti

doi:10.3889/oamjms.2019.296

Authors

Uwe Wollina StÃ¤dtisches Klinikum Dresden, Department of Dermatology and Allergology, Dresden, Germany
Gesina Hansel StÃ¤dtisches Klinikum Dresden, Department of Dermatology and Allergology, Dresden, Germany
Jacqueline SchÃ¶nlebe Institute of Pathology "Georg Schmorl", StÃ¤dtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
Birgit Heinig Center of Physical and Rehabilitative Medicine, StÃ¤dtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
Ivanka Temelkova Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
Georgi Tchernev Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
Aleksandra Vojvodic Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
Torello Lotti University of Rome Guglielmo Marconi Rome, Italy

DOI:

https://doi.org/10.3889/oamjms.2019.296

Keywords:

Eosinophilic fasciitis, Fibrotic disorders, Scleroderma, Treatment, Corticosteroids, Methotrexate

Abstract

BACKGROUND: Eosinophilic fasciitis is a rare fibrosing disorder of muscle fascia with rapid onset of erythema, induration, oedema and tenderness affecting extremities bilaterally.

CASE REPORT: We report three cases of eosinophilic fasciitis in 3 females aged 64, 65 and 73 years, in two of them in association with morphea. They fulfilled the proposed diagnostic criteria. Associated malignancies could be excluded in all of them. They were treated by systemic corticosteroids. In the two females with associated morphea higher prednisolone dosages and a combination with methotrexate was necessary.

CONCLUSIONS: Eosinophilic fasciitis is a differential diagnosis of systemic scleroderma. Response to treatment is often delayed. Systemic corticosteroids are the first line therapy. Patients with associated morphea need combined drug therapy, in our patients with methotrexate. There is no close correlation between laboratory signs of inflammation and clinical response to treatment.