Eosinophilic fasciitis presenting as inflammatory polyarthritis

Eosinophilic fasciitis is an uncommon disorder characterized by peripheral blood eosinophilia, hypergammaglobulinemia, and scleroderma-like inflammation of skin and fascia. Joint contractures occur but typically without synovitis and effusion. Our patient presented with symmetric polyarthritis and subsequently characteristic features of eosinophilic fasciitis developed. It is important to consider this disorder in patients presenting with arthritis as well as those presenting with skin changes because prior treatment with corticosteroids can alter biopsy findings, leading to diagnostic confusion, and possible adverse effects on the long-term treatment regimen.