musculoskeletal and connective tissue disorders
Eosinophilic Fasciitis
Key Points
Patients develop symmetric and painful swelling and induration of the arms and legs with a characteristic orange-peel appearance. Although cutaneous manifestations may suggest systemic sclerosis, patients with eosinophilic fasciitis usually do not have Raynaud syndrome, distal skin involvement often with telangiectasia, nail-fold changes, or visceral changes (eg, esophageal dysmotility). Confirm the diagnosis with a biopsy that includes fascia and adjacent muscle. Treat patients withprednisoneplusmethotrexateor another immunosuppressant ifmethotrexatecannot be used. 