Generalized morphea with peripheral eosinophilia, fasciitis and myositis

The distinctions between eosinophilic fascitis (Shulman's syndrome) and scleroderma may sometimes be unclear. We describe a patient with generalized morphea who also had peripheral blood eosinophilia, fibrosis and inflammation of fascia, and hyper-globulinemia, features usually attributed to Shulman's syndrome. The latter diagnosis should be restricted to those patients whose history, clinical and laboratory findings, and response to therapy closely resemble Shulman's original description. Scleroderma and eosinophilic fasciitis may represent slightly differing aspects of the same disease spectrum, with a similar immunologic pathogenesis.