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Morphoea-like plaques revealing an eosinophilic (Shulman) fasciitis

C Moulin1, A Cavailhes, B Balme

  • 1Dermatology Service, Centre Hospitalier de Valence, Valence, France.

Clinical and Experimental Dermatology
|October 22, 2009
PubMed

Insights

Eosinophilic fasciitis (EF) can present with morphoea-like plaques (MLPs) before fascial thickening. Early detection of MLPs indicates aggressive EF requiring prompt, intensive treatment.

Area of Science:

  • Rheumatology
  • Dermatology
  • Pathology

Background:

  • Eosinophilic fasciitis (EF) is a connective tissue disease primarily affecting the fascia.
  • Dermal involvement in EF can manifest as morphoea-like plaques (MLPs).
  • MLPs in EF are associated with a poor prognosis and refractory disease.

Observation:

  • This report details a unique case where MLPs preceded the characteristic fascial thickening of EF.
  • Clinical presentation of MLPs differs from classic morphoea, lacking lilac or ivory hues and exhibiting ill-defined borders.
  • Histological examination reveals a pronounced inflammatory infiltrate with increased eosinophils in MLPs.

Findings:

  • Morphoea-like plaques can be an early indicator of eosinophilic fasciitis.
  • MLPs associated with EF exhibit distinct clinical and histological features compared to classic morphoea.
  • Early identification of MLPs necessitates advanced imaging or biopsy for fascia evaluation.

Implications:

  • Prompt diagnosis of MLPs can lead to earlier detection of EF.
  • Aggressive treatment initiated early in EF, guided by MLP identification, may improve patient outcomes.
  • Recognizing MLPs as an early sign aids in differentiating EF from other connective tissue diseases.

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