Eosinophilic fascitis: A case report and literature review
Main Article Content
Keywords
Eosinophilic Fasciitis, Glucocorticoids, Immunosuppressive Agents, Biopsy
Abstract
Background: Eosinophilic fasciitis is a rare connective tissue disorder, characterized by inflammation and fibrosis of the deep fascia, with a heterogeneous clinical presentation and complex diagnosis. The objective was to describe a clinical case with a prolonged course, highlighting clinical, imaging, and histopathological features, as well as therapeutic response to combined immunosuppression.
Clinical case: A 49-year-old woman presented with progressive skin sclerosis, painful subcutaneous nodules, severe lower limb edema, and functional limitation. MRI revealed fascial thickening and STIR hyperintensity. Deep biopsy showed intravascular fascitis, fibrosis, and chronic inflammatory infiltrate. Diagnosis of eosinophilic fasciitis was established and treatment with prednisone and methotrexate was initiated. After 20 months of follow-up, it was observed clinical improvement, resolution of edema, and reduced skin induration.
Conclusions: Eosinophilic fasciitis can be confused with other scleroderma-like diseases, so early recognition and the use of specific diagnostic tools are essential. Combined treatment with corticosteroids and immunomodulators can induce remission and improve function, especially in cases with a prolonged course.
References
1. Chan KK, Magro C, Shoushtari A, et al. Eosinophilic fasciitis following checkpoint inhibitor therapy: Four cases and a review of literature. The Oncologist. 2020;25(2):140-9.doi: 10.1634/theoncologist.2019-0508
2. Henning PM, Mount GR, Kortan ND, et al. Eosinophilic fasciitis: Practice Essentials. EMedicine; 2024. Disponible en: https://emedicine.medscape.com/article/329515-overview
3. Pimentel León RR, García Chávez M, Chávez Sánchez IN. Fascitis eosinofílica: reporte de un caso clínico. Med Int Mex. 2024;40(5):276-82.doi: 10.24245/mim.v40i5.8054
4. Uddin A, Patnaik A, Lozeau D, et al. A complicated case of eosinophilic fasciitis with hematologic malignancy association. Cureus. 2024;16(7):e63912.doi: 10.7759/cureus.63912
5. Naschitz JE. Clinical guide to eosinophilic fasciitis: straddling dermatology and rheumatology. Expert Rev Clin Immunol. 2022;18(7):649-51. doi: 10.1080/1744666X.2022.2078309
6. Wang X, Zhang L, Hou Y, et al. Clinicopathological profile of eosinophilic fasciitis: a retrospective cohort study from a neuromuscular disorder center in China. Arthritis Res Ther. 2025;27(1):110. doi: 10.1186/s13075-025-03574-z
7. Selva O’Callaghan A, Trallero Araguás E, Gil Vila A, et al. Treatment and Monitoring of Eosinophilic Fasciitis. Curr Treatm Opt Rheumatol. 2025;11(3):3-4. doi: 10.1007/s40674-024-00222-6
8. Hamdan O, Alshajrawi R, Mussa Q, et al. Characteristics and factors associated with treatment response among patients with eosinophilic fasciitis: a systematic review and meta-analysis. Rheumatol Int. 2025;45:71. doi: 10.1007/s00296-025-05826-2
9. Mazilu D, Boltașiu Tătaru LA, Mardale DA, et al. Eosinophilic Fasciitis: Current and Remaining Challenges. Int J Mol Sci. 2023;24(3):1982. doi: 10.3390/ijms24031982
10. Gerritzen N, Küsters Vandevelde HV, Wevers RA, et al. Imaging of eosinophilic fasciitis in ultrasound and MRI: a case report. Eur J Radiol. 2024;155:113123. doi: 10.1016/j.ejrad.2022.113123
11. Kim J, Lee LH. Eosinophilic fasciitis diagnosed by MRI and clinical evaluation without biopsy in a 51-year-old woman: a case report. J Med Case Rep. 2023;17(1):151. doi: 10.1186/s13256-023-03881-6
12. Chohan S, Wong N, Hanson J, et al. Diagnostic imaging for eosinophilic fasciitis: a systematic review. JAAD Int. 2023;13:10-12. doi: 10.1016/j.jdin.2023.06.003
13. Londoño-Correa A, Londoño A, Ruiz AC, et al. Fascitis eosinofílica: reporte de un caso. Rev Colomb Reumatol. 2018;25(1):63-7. doi: 10.1016/j.rcreu.2017.03.001
14. Mertens JS, Seyger MM, Thurlings RM, et al. Morphea and eosinophilic fasciitis: an update. Am J Clin Dermatol. 2017;18(4):491-512. doi: 10.1007/s40257-017-0269-x
15. Ihn H. Eosinophilic fasciitis: From pathophysiology to treatment. Allergol Int. 2019;68(4):437-9. doi: 10.1016/j.alit.2019.03.001
16. Pinal-Fernández I, Milisenda JC, Selva-O’Callaghan A, et al. Eosinophilic fasciitis. Med Clin (Barc). 2025;165(4):107066. doi: 10.1016/j.medcli.2025.107066
17. Tull R, Hoover WD III, De Luca JF, et al. Eosinophilic fasciitis: a case series with an emphasis on therapy and induction of remission. Drugs Context. 2018;7:212529. doi: 10.7573/dic.212529
18. Jinnin M, Yamamoto T, Asano Y, et al. Diagnostic criteria, severity classification and guidelines of eosinophilic fasciitis. J Dermatol. 2018;45(8):881-90. doi: 10.1111/1346-8138.14160
19. Jinnin M. Treatment and Monitoring of Eosinophilic Fasciitis. Curr Treatm Opt Rheumatol. 2024. doi: 10.1007/s40674-024-00222-6
20. Fornés O, Boada P, Cuberas M, et al. Cuando unos edemas no son lo que parecen. Med Gen Fam. 2023;12(2):77-9. doi: 10.24038/mgyf.2023.016
21. Mahdi AS, Nasr IH, Al Jahdhami S, et al. Eosinophilic fasciitis responds well to steroids and methotrexate. Oman Med J. 2019;34(6):564-7. doi: 10.5001/omj.2019.102
22. Xu Y, Wang H, Li Y, et al. Recurrent eosinophilic fasciitis: the first case report. Clin Cosmet Investig Dermatol. 2025;18:415-21. doi: 10.2147/CCID.S465667
23. Khadka A, Crawford R, Chaffins M. Eosinophilic fasciitis presenting with unilateral hand involvement in a young adult. Cureus. 2025;17(6):e51940. doi: 10.7759/cureus.51940
24. Wang Y, Yu Y, Zhang J, et al. Eosinophilic fasciitis with widespread rash and joint contracture: a case report. Medicine (Baltimore). 2024;103(16):e37928. doi: 10.1097/MD.0000000000037928
25. Li Y, Kong HE, Cheeley J, et al. Eosinophilic fasciitis following COVID-19: A case series of 3 patients. JAAD Case Rep. 2023;44:6-10. doi: 10.1016/j.jdcr.2023.11.019
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.