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The fasciitis-panniculitis syndromes. Clinical and pathologic features
J E Naschitz1, J H Boss, I Misselevich
1Department of Medicine, Bnai-Zion Medical Center, Haifa, Israel.
Medicine
|January 1, 1996
Summary
Fasciitis-panniculitis syndromes (FPS) encompass diverse disorders causing skin induration. Cimetidine shows promise as a first-line treatment for these conditions, including eosinophilic fasciitis.
Area of Science:
- Dermatology
- Rheumatology
- Pathology
Background:
- Fasciitis-panniculitis syndromes (FPS) are characterized by skin induration from chronic inflammation and fibrosis.
- Eosinophilic fasciitis is the prototype disorder within this group.
- Understanding the diversity and shared features of FPS is crucial for diagnosis and treatment.
Purpose of the Study:
- To analyze the clinical presentations, histologic features, and treatment responses in patients with fasciitis-panniculitis syndromes.
- To evaluate the efficacy of cimetidine as a treatment for FPS.
- To propose a unifying concept for fasciitis-panniculitis syndromes.
Main Methods:
- Retrospective analysis of 32 consecutive patients diagnosed with FPS over a 10-year period.
- Review of clinical data, skin biopsy findings, and treatment outcomes.
- Categorization of FPS based on etiology (idiopathic, vascular, infectious, neoplastic, etc.).
Main Results:
- Idiopathic FPS (eosinophilic fasciitis) was diagnosed in 14 patients; 18 cases were associated with other disorders.
- Common histologic findings included septal/fascial fibrosis, chronic inflammation, and small-vessel vasculopathy.
- Complete remission was achieved in 3 of 5 patients treated with cimetidine monotherapy.
Conclusions:
- The concept of FPS highlights clinical and etiologic diversity, a stereotypic tissue reaction, and the panniculitic component.
- Cimetidine may be recommended as a first-line treatment for fasciitis-panniculitis syndromes.
- Further research into FPS and cimetidine's role is warranted.