Eosinophilic fasciitis presenting as inflammatory polyarthritis

Area of Science:

• Rheumatology
• Dermatology
• Immunology

Background:

• Eosinophilic fasciitis is a rare connective tissue disease.
• It typically involves inflammation of the fascia and skin.
• Peripheral blood eosinophilia and hypergammaglobulinemia are characteristic laboratory findings.

Observation:

• The patient presented with symmetric polyarthritis, mimicking other rheumatologic conditions.
• Characteristic skin and fascial changes of eosinophilic fasciitis developed subsequently.
• Joint contractures were present, but without typical signs of synovitis or effusion.

Findings:

• The case highlights the potential for eosinophilic fasciitis to manifest initially with arthritic symptoms.
• Scleroderma-like skin and fascial inflammation are key diagnostic features.
• The differential diagnosis should include eosinophilic fasciitis in patients with unexplained arthritis and skin changes.

Implications:

• Considering eosinophilic fasciitis early in the diagnostic workup is essential.
• Corticosteroid treatment prior to biopsy can complicate diagnosis by altering pathological findings.
• Prompt and accurate diagnosis is crucial for appropriate long-term management and to avoid treatment complications.