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Eosinophilic fasciitis. A pathologic study of twenty cases
The American Journal of Pathology
|August 1, 1979
Summary
Eosinophilic fasciitis involves inflammation and thickening of deep fascia, with early edema and later collagenization. Immunologic factors may initiate this disorder, affecting fascia, subcutis, and sometimes joints.
Area of Science:
- Pathology
- Rheumatology
- Dermatology
Background:
- Eosinophilic fasciitis is a disorder featuring deep fascia inflammation and thickening.
- Key characteristics include hypergammaglobulinemia, and peripheral and tissue eosinophilia.
Purpose of the Study:
- To present a detailed light-microscopic evaluation of biopsies from patients with eosinophilic fasciitis.
- To elucidate the pathological progression and potential immunologic basis of the disorder.
Main Methods:
- Light-microscopic examination of biopsies from 20 patients.
- Direct immunofluorescence studies on eight biopsies.
Main Results:
- Early disease shows edematous fascia and subcutis infiltrated by inflammatory cells and eosinophils.
- Progressive stages reveal collagenization, thickening, and sclerosis of fascia, subcutis, and dermis.
- Extracutaneous involvement included synovitis and tenosynovitis; immunoglobulin/complement deposits found in 5/8 biopsies.
Conclusions:
- Eosinophilic fasciitis progresses from inflammation to fibrotic changes in deep connective tissues.
- Findings suggest a potential immunologic stimulus initiating the syndrome.
- Differential diagnoses for this condition are discussed.