Unilateral Eosinophilic Fasciitis With Hand Involvement: A Case Report

Area of Science:

• Rheumatology
• Dermatology
• Systemic Connective Tissue Diseases

Background:

• Eosinophilic fasciitis (EF) is a rare systemic connective tissue disease.
• It involves chronic inflammation of the muscle fascia and subcutaneous tissue.
• Pathogenesis remains poorly understood, with diagnosis relying on clinical, imaging, and histological findings.

Purpose of the Study:

• To report a unique case of eosinophilic fasciitis with an unusual asymmetric presentation and hand involvement.
• To review classic diagnostic criteria for eosinophilic fasciitis.
• To discuss the potential to avoid full-thickness skin biopsy in favor of early treatment.

Main Methods:

• Case report of a 24-year-old male with eosinophilic fasciitis.
• Diagnosis based on physical examination, laboratory results, and MRI imaging.
• Treatment involved initial steroid therapy followed by steroid-sparing agents.

Main Results:

• The patient presented with predominantly asymmetric symptoms and hand involvement.
• Key diagnostic features included physical exam findings, labs, and MRI.
• The patient showed improvement with corticosteroid treatment and transitioned to steroid-sparing therapy.

Conclusions:

• Eosinophilic fasciitis can manifest with atypical presentations, including asymmetry and hand involvement.
• Early diagnosis and treatment are crucial for managing eosinophilic fasciitis.
• In select cases, early treatment may be considered without a full-thickness skin biopsy.