Compartment syndrome as a late complication of eosinophilic fasciitis

Eosinophilic fasciitis (EF) was diagnosed in a 23-year-old man presenting characteristic symptoms, skin changes, blood eosinophilia and typical histology showing thickened deep dermal fascia with inflammatory cells. After one year of corticosteroid treatment he experienced increasing pain in both legs and fluctuating serum creatinine kinase levels. Direct measurement showed elevated resting intracompartment pressure and both static strain and dynamic exercise provoked the typical pain. At operation all 4 compartments of both legs were decompressed and he recovered uneventfully. The compartment syndrome may be a hitherto unknown, but expected complication of severe EF.