Eosinophilic fasciitis (Shulman's disease)

Eosinophilic fasciitis is an uncommon connective tissue disorder characterized by symmetrical thickening and hardening of the skin and underlying fascia, mainly involving the extremities. Usually, it is not associated with internal organ involvement, unlike other fibrosing disorders. It is associated with peripheral eosinophilia, elevated inflammatory markers, and hypergammaglobulinemia. Biopsy findings are typical. The etiology and pathogenesis are poorly understood. Associations with statin therapy, preceding extreme exertion, insect bite, and borreliosis are reported.

As this is a very rare condition, guidelines for management are currently not available. However, corticosteroids remain the mainstay of treatment.

This case report describes a 30-year-old female with clinical findings of eosinophilic fasciitis. Diagnosis was proved by histology and MRI findings. Her condition improved considerably with steroid therapy and physiotherapy.