eMedicine Specialties > Dermatology > Connective Tissue Diseases

Eosinophilic Fasciitis: Multimedia

Author: Brad S Graham, MD, Consulting Staff, Dermatology Associates of Tyler
Contributor Information and Disclosures

Updated: Jun 19, 2009

Multimedia

Lower back part of the legs shows hypopigmentatio...Media file 1: Lower back part of the legs shows hypopigmentation, induration, biopsy site, and asymmetric involvement (same patient as in Media Files 2-3).
Lower back part of the legs shows hypopigmentatio...

Lower back part of the legs shows hypopigmentation, induration, biopsy site, and asymmetric involvement (same patient as in Media Files 2-3).

Posterior thigh shows woody induration, sclerosis...Media file 2: Posterior thigh shows woody induration, sclerosis, and hypopigmentation (same patient as in Media Files 1 and 3).
Posterior thigh shows woody induration, sclerosis...

Posterior thigh shows woody induration, sclerosis, and hypopigmentation (same patient as in Media Files 1 and 3).

Close-up view of left posterior thigh 2 weeks lat...Media file 3: Close-up view of left posterior thigh 2 weeks later shows erythema, scaling, alopecia, and rippled induration (same patient as in Media Files 1-2).
Close-up view of left posterior thigh 2 weeks lat...

Close-up view of left posterior thigh 2 weeks later shows erythema, scaling, alopecia, and rippled induration (same patient as in Media Files 1-2).

Posterior part of the calf in the first week of i...Media file 4: Posterior part of the calf in the first week of illness shows erythema, edema, alopecia, scaling, and early induration. The right calf is relatively uninvolved with patchy erythema only (same patient as in Media File 5).
Posterior part of the calf in the first week of i...

Posterior part of the calf in the first week of illness shows erythema, edema, alopecia, scaling, and early induration. The right calf is relatively uninvolved with patchy erythema only (same patient as in Media File 5).

Photograph of the posterior part of the calf at 3...Media file 5: Photograph of the posterior part of the calf at 3 weeks shows complete sclerosis and induration with patchy erythema (same patient as in Media File 4).
Photograph of the posterior part of the calf at 3...

Photograph of the posterior part of the calf at 3 weeks shows complete sclerosis and induration with patchy erythema (same patient as in Media File 4).

Note the marked thickening and replacement of the...Media file 6: Note the marked thickening and replacement of the entire dermis with sclerotic collagen on this incisional biopsy sample from the left posterior part of the thigh.
Note the marked thickening and replacement of the...

Note the marked thickening and replacement of the entire dermis with sclerotic collagen on this incisional biopsy sample from the left posterior part of the thigh.

Photomicrograph of subcutaneous fat-fascia juncti...Media file 7: Photomicrograph of subcutaneous fat-fascia junction shows entrapment of subcutaneous fat by intersecting thick bands of fibrosis. Thickening and fibrosis of fascia and lymphoid aggregates are seen.
Photomicrograph of subcutaneous fat-fascia juncti...

Photomicrograph of subcutaneous fat-fascia junction shows entrapment of subcutaneous fat by intersecting thick bands of fibrosis. Thickening and fibrosis of fascia and lymphoid aggregates are seen.

Photomicrograph of fascia-skeletal muscle junctio...Media file 8: Photomicrograph of fascia-skeletal muscle junction shows markedly thickened fascia with heavy inflammatory infiltration.
Photomicrograph of fascia-skeletal muscle junctio...

Photomicrograph of fascia-skeletal muscle junction shows markedly thickened fascia with heavy inflammatory infiltration.

High-power photomicrograph of fascia shows heavy ...Media file 9: High-power photomicrograph of fascia shows heavy inflammatory infiltration with numerous eosinophils, lymphocytes, and occasional plasma cells.
High-power photomicrograph of fascia shows heavy ...

High-power photomicrograph of fascia shows heavy inflammatory infiltration with numerous eosinophils, lymphocytes, and occasional plasma cells.

More on Eosinophilic Fasciitis

Overview: Eosinophilic Fasciitis
Differential Diagnoses & Workup: Eosinophilic Fasciitis
Treatment & Medication: Eosinophilic Fasciitis
Follow-up: Eosinophilic Fasciitis
Multimedia: Eosinophilic Fasciitis
References

References

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  2. Serrano-Grau P, Mascaró-Galy JM, Iranzo P. Eosinophilic fasciitis after taking simvastatin. Actas Dermosifiliogr. Jun 2008;99(5):420-1. [Full Text].

  3. Anton E. Failure to demonstrate Borrelia burgdorferi-specific DNA in lesions of eosinophilic fasciitis. Histopathology. Jul 2006;49(1):88-90. [Medline].

  4. Jinnin M, Ihn H, Yazawa N, Asano Y, Yamane K, Tamaki K. Elevated serum levels of manganese superoxide dismutase in patients with eosinophilic fasciitis. Clin Rheumatol. Dec 2003;22(6):505. [Medline].

  5. Jinnin M, Ihn H, Yamane K, Asano Y, Yazawa N, Tamaki K. Serum levels of tissue inhibitor of metalloproteinase-1 and 2 in patients with eosinophilic fasciitis. Br J Dermatol. Aug 2004;151(2):407-12. [Medline].

  6. Sherber NS, Wigley FM, Paget SA. Diffuse fasciitis with eosinophilia developing after local irradiation for breast cancer. Clin Rheumatol. Jun 2009;28(6):729-32. [Medline].

  7. Endo Y, Tamura A, Matsushima Y, Iwasaki T, Hasegawa M, Nagai Y. Eosinophilic fasciitis: report of two cases and a systematic review of the literature dealing with clinical variables that predict outcome. Clin Rheumatol. Sep 2007;26(9):1445-51. [Medline].

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  15. Romano C, Rubegni P, De Aloe G, et al. Extracorporeal photochemotherapy in the treatment of eosinophilic fasciitis. J Eur Acad Dermatol Venereol. Jan 2003;17(1):10-3. [Medline].

  16. Tzaribachev N, Holzer U, Schedel J, Maier V, Klein R, Kuemmerle-Deschner J. Infliximab effective in steroid-dependent juvenile eosinophilic fasciitis. Rheumatology (Oxford). Jun 2008;47(6):930-2. [Medline].

  17. Haiduc VF, Erkan D, Kirou K, Birchansky S, Park J, Danon MJ. Anti-neutrophil Cytoplasmic Antibody (c-ANCA) Positive Recurrent Eosinophilic Fasciitis Responsive to Cyclophosphamide : A Clinical Pathology Conference Held by the Division of Rheumatology at Hospital for Special Surgery. HSS J. Feb 2008;4(1):81-6. [Medline][Full Text].

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  20. Horacek E, Sator PG, Gschnait F. 'Venous furrowing': a clue to the diagnosis of eosinophilic fasciitis. A case of eosinophilic fasciitis ultimately treated with oral PUVA therapy. Dermatology. 2007;215(1):89-90. [Medline].

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  22. Khalifa M, Slim I, Ghannouchi N, et al. Eosinophilic fasciitis and toxic thyroid adenoma--a novel association. Acta Clin Belg. May-Jun 2008;63(3):197-9.

  23. Tahara K, Yukawa S, Shoji A, Hayashi H, Tsuboi N. Long-term remission by cyclosporine in a patient with eosinophilic fasciitis associated with primary biliary cirrhosis. Clin Rheumatol. Sep 2008;27(9):1199-201. [Medline].

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  27. Toquet C, Hamidou MA, Renaudin K, et al. In situ immunophenotype of the inflammatory infiltrate in eosinophilic fasciitis. J Rheumatol. Aug 2003;30(8):1811-5. [Medline].

Further Reading

Keywords

eosinophilic fasciitis, Shulman syndrome, morphea, fascial fibrosis, joint contractures, arthritis, neuropathy, myositis

Contributor Information and Disclosures

Author

Brad S Graham, MD, Consulting Staff, Dermatology Associates of Tyler
Brad S Graham, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, and Texas Dermatological Society
Disclosure: Nothing to disclose.

Medical Editor

Ponciano D Cruz Jr, MD, Vice-Chair, JB Shelmire Professor, Department of Dermatology, University of Texas Southwestern Medical Center
Ponciano D Cruz Jr, MD is a member of the following medical societies: Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Edward F Chan, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine
Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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