Allergy Asthma Immunol Res.  2014 Mar;6(2):179-182. 10.4168/aair.2014.6.2.179.

A Case of Eosinophilic Fasciitis Presenting as Pitting Edema of the Lower Extremities

• Lee HS
• Chang SJ
• Kang MS
• Yoon CS
• Kim KW
• Sohn MH
• Kim KE

• KMID: 2260265
• DOI: http://doi.org/10.4168/aair.2014.6.2.179

Abstract

Eosinophilic fasciitis is a rare disease characterized by diffuse fasciitis with peripheral eosinophilia and progressive induration and thickening of the skin and soft tissues. We report a 19-year-old female who presented with pitting edema in both lower extremities. She had a history of excessive physical activity before her symptoms developed. Physical examination revealed 2+ pitting edema in both lower legs. She complained of mild pain in both knee joints and feet, with no tenderness or heating sensations. Laboratory results were unremarkable except for severe eosinophilia. Parasite infection, venous thrombosis, and cardiac and renal problems were excluded. A magnetic resonance imaging study of both lower extremities revealed increased signal intensity in the subcutaneous lesions, consistent with superficial inflammation of the fascia. Mixed perivenular lymphoplasmacytic and eosinophilic infiltration in the subcutaneous lesion were observed on biopsy. The patient was treated with corticosteroids, resulting in remarkable improvement in both edema and eosinophilia.

Keyword

Eosinophilia; eosinophilic fasciitis; pitting edema

MeSH Terms

Adrenal Cortex Hormones
Biopsy
Edema*
Eosinophilia
Eosinophils*
Fascia
Fasciitis*
Female
Foot
Hot Temperature
Humans
Inflammation
Knee Joint
Leg
Lower Extremity*
Magnetic Resonance Imaging
Motor Activity
Physical Examination
Rare Diseases
Skin
Young Adult
Adrenal Cortex Hormones

Figure

• 

  Fig. 1 Fat-saturated T2-weighted magnetic resonance imaging of the lower thigh of a patient with eosinophilic fasciitis. Arrows indicate inflammatory changes in the superficial fascia and subcutaneous fat layer.

• 

  Fig. 2 Perivascular eosinophilic infiltration in deep dermal and subcutaneous fat tissue (×400).

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