musculoskeletal and connective tissue disorders
Eosinophilic Fasciitis
Treatment of Eosinophilic Fasciitis
Oralprednisone Methotrexate Most patients respond rapidly to high doses ofprednisone(40 to 60 mg once a day followed by gradual reduction to 5 to 10 mg a day as soon as the fasciitis resolves). Continued low doses may be required for a few years. Despite a scarcity of controlled drug trials to guide therapy, observational data have shown that the combination of corticosteroids andmethotrexateis more likely to lead to complete treatment response than corticosteroids alone. Ifmethotrexateis contraindicated, other drugs such asazathioprineormycophenolatemofetil can be used as well. Physical therapy may help with flexion contractures. Monitoring with complete blood counts is advised because hematologic complications occasionally occur. Surgical release of contractions and the carpal tunnel may be necessary. (see Prevention ), and vaccines against common infections (eg, 