Eosinophilic Fasciitis- Information, Treatment & Prevention

By: Juliet Cohen

The eosinophilic fasciitis is a disorder idiopathic and fibrotic with the seal histopathologic of the fibrosis fascial. The causes is unknown, but aberrant immune responses may play a role because hypergammaglobulinemia and antinuclear antibodies are associated. The name eosinophilic refers to the initially high blood levels of a type of white blood cell called eosinophils. Fasciitis refers to inflammation of the fascia, which is the tough fibrous tissue that lies beneath the skin. Eosinophilic fasciitis occurs equally in males and females. Borrelia burgdorferi may be a possible etiologic agent in some cases. Eosinophilic fasciitis is sometimes confused with eosinophilia myalgia syndrome and scleroderma. Eosinophilic fasciitis sometimes occurs associated with cancers, such as leukemia and lymphoma.

Eosinophilic fasciitis is a specific disease of the skin that leads to inflammation and thickening of the skin and fascia underneath. The disorder occurs mainly in men aged 40 to 50, but it may occur in women and children. The disease is considered by some to be a deep variant of the skin condition, morphoea. In addition, eosinophilic fasciitis is known to occur in persons with other autoimmune disorders, including autoimmune thyroiditis, sjogren's syndrome, alopecia areata, vitiligo, and autoimmune thrombocytopenia. Typically, eosinophilic fasciitis does not involve the fingers and toes. Muscle strength is unimpaired, but myalgia and arthritis may occur. Arthritis is a rare complication of eosinophilic fasciitis. Some patients may develop blood-related cancers.

In patients with eosinofiele fasciitis, the involved link has been lighted with the eosinophil type of white blood warrants. This frequently leads to symptoms of progressive thick making and redness, warmth, and hardness of the skin surface. The skin of the face, chest, and abdomen may occasionally be affected also. In contrast to scleroderma, the skin of the feet and hands is not affected and raynaud's phenomenon does not occur. Symptoms usually progress gradually. After weeks, the inflamed skin begins to harden, eventually acquiring a texture similar to an orange peel. Weight loss and fatigue are common. Restriction occurs because the fascia is affected to a greater degree than the skin. Muscle strength does not usually decrease, but muscle and joint pain may occur. Rarely, if the arms are involved, the person may develop carpal tunnel syndrome.

The diagnosis of eosinophilic fasciitis is made with a biopsy of a full thickness of involved skin. No consensus on the treatment of eosinophilic fasciitis exists, but most studies indicate that the best response is with moderate-to-high doses of corticosteroids. Treatment should be started as early as possible to prevent scarring, tissue loss, and contractures. Surgical decompression of carpal tunnel syndrome may be required. Active and passive range of motion therapy of the involved extremities and joints is crucial along with medical therapy to prevent and to treat joint contractures. Prednisone helps some people but not all. Nonsteroidal anti-inflammatory drugs may also help relief symptoms. In more severe cases, prednisone may be used, along with immune suppression medications such as cyclophosphamide and methotrexate.

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