Eosinophilic fasciitis with subjacent myositis

Area of Science:

• Rheumatology
• Neurology
• Dermatology

Background:

• Eosinophilic fasciitis (EF) is a rare connective tissue disorder.
• It can present with symptoms that overlap with neuromuscular conditions.
• Early recognition is crucial for effective management.

Observation:

• A 43-year-old woman experienced chronic muscle pain, tightness, and stiffness.
• She had hypertrophied muscles despite inactivity, and skin changes including thickening, discoloration, and reduced elasticity.
• Initial laboratory and electrodiagnostic studies were unremarkable for neuromuscular disease.

Findings:

• Magnetic resonance imaging revealed characteristic fascial thickening and inflammation.
• Fascial and muscle biopsy confirmed eosinophilic infiltration and fascial changes diagnostic of EF.
• Treatment with methotrexate and prednisone led to symptom improvement.

Implications:

• EF should be considered in the differential diagnosis of unexplained muscle pain and enlargement.
• This case highlights the importance of comprehensive diagnostic evaluation, including advanced imaging and biopsy.
• Timely diagnosis and immunosuppressive therapy can significantly alleviate symptoms and improve patient outcomes.