Eosinophilic Fasciitis Responds Well to Steroids and Methotrexate

Eosinophilic fasciitis (EF) is a rare systemic inflammatory disease with an unknown etiology. Making a diagnosis in such a case is always a challenge as it is a rare disease and mimics scleroderma and scleroderma-like syndrome but should be kept in mind as it carries a high mortality. Furthermore, it is a treatable disease. Here, we report a 41-year-old woman who presented to the rheumatology clinic at the Royal Hospital, Muscat, Oman, with a one-month history of bilateral swelling of the forearms along with skin tightness and fingers contraction. Her history and physical examination along with histopathological examination and magnetic resonance imaging findings were consistent with EF. She showed an excellent response to steroids and methotrexate which is not a combination therapy that has been tried or mentioned previously.

Unraveling Shulman's syndrome: A rare case of eosinophilic fasciitis in a pediatric patient with fascial abnormalities on MRI

We report the case of a 15-year-old girl who presented with a 2-month history of severe fatigue and rapidly worsening myalgia. Biological tests revealed hypereosinophilia and an inflammatory syndrome. MRI showed increased signal intensity in the superficial and deep aponeurotic layers on T2-weighted images, with moderate fascia enhancement after contrast administration. A muscle biopsy of the arm was performed, revealing an accumulation of eosinophils in the muscle aponeuroses. Eosinophilic fasciitis (EF) is a rare connective tissue disorder characterized by inflammation of the fascia, leading to skin thickening and limb pain. While it predominantly affects adults, pediatric cases are rare, making diagnosis challenging due to its overlap with other fibrotic diseases.