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Medicina Clínica (English Edition) Eosinophilic fasciitis
Journal Information
Vol. 165. Issue 4.
(October 2025)
Review
Eosinophilic fasciitis
Fascitis eosinofílica
Iago Pinal-Fernándeza,b,
Corresponding author
iago.pinalfernandez@nih.gov

Corresponding author.
, José César Milisendac, Albert Selva-O’Callaghand
a Muscle Disease Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, United States
b Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
c Muscle Research Unit, Internal Medicine Service, Hospital Clinic. Barcelona University; CIBERER and IDIBAPS, Barcelona, Spain
d Systemic Autoimmune Diseases Unit, Internal Medicine Department Vall d’Hebron General Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
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Table 1. Diagnostic criteria for eosinophilic fasciitis.
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Table 2. Differential diagnosis of eosinophilic fasciitis.
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Abstract

Eosinophilic fasciitis is a rare scleroderma-like syndrome of unknown cause. It is characterised by painful induration and progressive thickening of the muscular fascia and subcutaneous tissue of the limbs and trunk. The most common laboratory findings include peripheral eosinophilia, hypergammaglobulinemia, and an elevated erythrocyte sedimentation rate. The diagnosis is confirmed through a full-thickness wedge biopsy of the affected skin, revealing inflammation and thickening of the deep fascia.

The differential diagnosis includes scleroderma, morphea, myofasciitis in graft-versus-host disease, and epidemic fasciitis syndromes caused by toxins, such as eosinophilia-myalgia syndrome and toxic oil syndrome. Although the diagnosis is based on clinical, laboratory, and histological findings, no universal diagnostic criteria exist. Glucocorticoids are the standard treatment, although some patients may improve spontaneously.

Keywords:
Eosinophilic fasciitis
Myopathy
Fasciitis
Eosinophils
Scleroderma-like syndrome
Resumen

La fascitis eosinofílica es un síndrome esclerodermiforme raro de causa desconocida. Se caracteriza por induración dolorosa y engrosamiento progresivo de la fascia muscular y el tejido subcutáneo de las extremidades y el tronco. Los hallazgos de laboratorio más frecuentes incluyen eosinofilia periférica, hipergammaglobulinemia y velocidad de sedimentación globular elevada. El diagnóstico se confirma mediante una biopsia en cuña de espesor completo de la piel afectada, que revela inflamación y engrosamiento de la fascia profunda.

El diagnóstico diferencial incluye esclerodermia, morfea, miofascitis en enfermedad injerto contra huésped y síndromes de fascitis epidémica causados por toxinas, como el síndrome de mialgia-eosinofilia y el síndrome del aceite tóxico. Aunque el diagnóstico se basa en hallazgos clínicos, de laboratorio e histológicos, no existen criterios diagnósticos universales. Los glucocorticoides son el tratamiento estándar, aunque algunos pacientes pueden mejorar espontáneamente.

Palabras clave:
Fascitis eosinofílica
Miopatía
Fascitis
Eosinófilos
Síndrome esclerodermiforme

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