Eosinophilic fasciitis associated with myositis

Area of Science:

• Rheumatology
• Dermatology
• Pathology

Background:

• Eosinophilic fasciitis (EF) is a rare inflammatory disorder affecting the fascia.
• It typically presents with symmetrical, scleroderma-like skin thickening and pain.
• Histologically, EF shows fascial inflammation with eosinophils and lymphocytes, and fascial fibrosis.

Observation:

• A 69-year-old Japanese woman presented with painful, glossy indurations and peau d'orange lesions.
• Magnetic resonance imaging revealed thickened fascia in the lower extremities.
• Histopathology showed fascial and muscle degeneration with eosinophilic and lymphocytic infiltration, predominantly CD8+ T-cells.

Findings:

• The patient was diagnosed with eosinophilic fasciitis with myositis.
• Treatment with oral prednisolone and exercise cessation led to significant improvement.
• This suggests a positive response to immunosuppression and reduced physical stress.

Implications:

• This case expands the understanding of eosinophilic fasciitis presentation and diagnosis.
• It underscores the importance of considering myositis in EF cases.
• The findings support the efficacy of corticosteroid therapy and activity modification in managing EF.