Scleroderma, eosinophilia, and diffuse fasciitis

Abstract

Skin induration without internal organ involvement, blood and tissue eosinophilla, and fascilitis are features of diffuse fascilitis. However, cellular infiltrates (lymphocytes, plasma cells, and eosinophils) may also be present in the dermis, fat, and muscle. Blood eosinophilia (mild and transient) and skin eosinophilia were observed in about 20% of patients with systemic and localized scleroderma.

Polymyositis in Eosinophilic Fasciitis

“…Mild, Raynaud's phenomena or visceral involvement have been described only as exceptions in eosinophilic fasciitis. Eosinophilia in systemic sclerosis might be more common than previ ously thought (Fleischmajer et al, 1978) and has recently been reported in a case with severe prognosis (Don et al, 1978). In some patients, differential diagnosis from eosinophilic fasciitis will thus remain difficult.…”

“…Both epidermal symptoms and the increased thickness of the dermis are 'sclero derma-like' (Chevrant-Breton et al, 1977;Fleischmajer et al, 1978;Gray and Poppu, 1977;Nassonova et al, 1978;Rodnan et al, 1975;Shumacher, 1976), although histological changes of scleroderma never have been found. Clinical differences have been the absence of telangiectases and sclerodactylia.…”

“…The majority have so far been observed by rheumatologists (Bennet et a l, 1977;Caperton et al, 1976;Gray and Poppo, 1977;Nassonova et al, 1978;Rodnan et a/., 1975a, b;Shulman, 1974Shulman, , 1975aShumacher, 1976;Sokoloff personal commun., 1977;Strom et al, personal commun., 1977;Stubbs and Hughes, 1976;Talbott and Cusani, 1976) but reports have also appeared in dermatological journals (Chevrant-Breton et al, 1977;Fleischmajer et al, 1978;Torres and George, 1977;Weinstein and Schwartz, 1978). The main symptoms (table I) are swelling and stiffening of skin on arms and legs with diffi culties of movement due to flexion contrac tures, weakness and muscle pain.…”

Capillary Microscopy in Eosinophilic Fasciitis

“…Some authors have suggested that EF is a variant in the clinical spectrum of progressive systemic sclerosis, rather than a distinct disease entity (23)(24)(25)(26)(27). Although the etiology of both EF and PSS is unknown, microcirculation is a key factor in the pathologic changes that develop in PSS (28).…”

Eosinophilic fasciitis.

“…Other types of scleroderma may also have blood eosinophilia. [8][9][10] On the other hand, sclerosis of the skin and soft tissue occurs in many processes other than scleroderma and its variants. 5 …”