Fasciitis eosinophilica: personal observations and a review of the literature

Eosinophilic fasciitis is a rare disease that is classified by some authors to scleroderma-like syndromes. Symmetrical induration of skin and subcutaneous tissue associated by eosinophilia in peripheral blood are characteristic features of the disease. Internal organ involvement is uncommon. It is often difficult to diagnose eosinophilic fasciitis and its course may be variable. Glucocorticosteroids are most commonly used in the treatment but in many cases they are ineffective. Then other immunosuppressive therapy must be considered. Prognosis is rather favorable. The remission is not always achieved and sometimes flares of the disease are observed as evidenced by the described cases. It should be emphasized that a majority of our patients were females. In four out of five patients anti-thyreoglobulin antibodies and/or anti-thyroid peroxidase antibodies were present suggesting their involvement in the pathogenesis of eosinophilic fasciitis. Neither indicators of inflammation nor peripheral blood eosinophilia were pathognomonic. Results of glucocorticosteroid treatment were satisfactory in three patients, but two patients required combined immunosuppressive treatment.