A case of eosinophilic fasciitis dramatically responded to steroid therapy

Eosinophilic fasciitis was observed in a 43-year-old woman who developed subcutaneous induration of the distal extremities accompanying peripheral eosinophilia. This patient showed the decreased power of grasp and gait disturbance due to flexion contracture of the knees. On admission, laboratory examinations revealed peripheral eosinophilia, positive CRP, a slightly high titer of ANA, positive LE test and elevated level of immune complex. The deep fascias remarkable thickened with infiltrated mononuclear cells which were detected in the biopsy specimen of the lesion. Application of corticosteroid resulted in dramatic improvement on the mobility of her knee joints in two days. Laboratory data revealed normal level of eosinophils and immune complex, negative CRP, ANA and LE test after the treatment. Early diagnosis and steroid therapy are inevitable in such cases associated with progressive systemic sclerosis without involvement of internal organs as this case reported here. It was suggested that eosinophilic fasciitis might be included in one of the autoimmune disease according to the findings of butterfly rash, positive LE test and ANA observed in this case.