Diffuse (eosinophilic) fasciitis. A series of six cases

Six patients with diffuse fasciitis are described. Their ages range from 12 to 45 years. Five had a typical clinical illness which responded well to corticosteroid therapy but one patient relapsed a year after discontinuation of corticosteroids. One patient had severe skin ulceration resistant to corticosteroids, cytotoxics and plasma exchange and was further complicated by the development of life threatening local and generalised sepsis. Eosinophilia of the blood was not present in any of the cases and not unduly prominent in biopsies of the affected tissue, but characteristic fascial thickening and infiltration by chronic inflammatory cells was diagnostic when a full-thickness biopsy was examined. The natural history and optimal treatment of this condition remain unclear.