Eosinophilic Fasciitis
(Shulman's Syndrome)

Medical Author: William C. Shiel Jr., MD, FACP, FACR

• What are eosinophils?
• What is fascia?
• What is eosinophilic fasciitis?
• How is eosinophilic fasciitis diagnosed?
• How is eosinophilic fasciitis treated?

What are eosinophils?

Eosinophils are a particular type of white blood cells, usually representing a small percentage (less than 8% of the total white blood cell population). The number of these cells (eosinophil count) increases in certain illnesses, including allergies, asthma, Addison's disease, sarcoidosis, parasite infections, drug reactions, and connective tissue diseases (such as rheumatoid arthritis and scleroderma).

What is fascia?

The fascia is a lining tissue under the skin that covers a surface of underlying tissues. When the fascia is inflamed, the condition is referred to as "fasciitis."

What is eosinophilic fasciitis?

Eosinophilic fasciitis is a specific disease of the skin that leads to inflammation and thickening of the skin and fascia underneath. In patients with eosinophilic fasciitis, the involved fascia is inflamed with the eosinophil type of white blood cells. This leads to symptoms of progressive thickening and often redness, warmth, and hardness of the skin surface.

Occasionally, the onset of eosinophilic fasciitis follows a period of exertional physical activity. Eosinophilic fasciitis is sometimes confused with eosinophilia-myalgia syndrome and scleroderma. Eosinophilic fasciitis sometimes occurs associated with cancers, such as leukemia and lymphoma.

How is eosinophilic fasciitis diagnosed?

The diagnosis of eosinophilic fasciitis is made with a biopsy of a full thickness of involved skin.

How is eosinophilic fasciitis treated?

Treatment of eosinophilic fasciitis is directed at eliminating the tissue inflammation and includes aspirin, other antiinflammatory drugs (NSAIDs), and cortisone. Many patients will improve spontaneously. Others can be afflicted with persistent tissue and joint pain, in addition to thickening of the involved tissues.

For aggressive eosinophilic fasciitis, cortisone medications (such as prednisone and prednisolone) are considered along with immune suppression medications (such as cyclophosphamide [Cytoxan] and penicillamine [Depen, Cuprimine]).

Recent medical research has shown that the immune-suppression drug methotrexate can provide an added benefit in treating eosinophilic fasciitis. This methotrexate research strongly suggests that methotrexate can reduce both the immune inflammation and the need for continued cortisone medications.

From the Doctors at MedicineNet.com

Scleroderma - Read about scleroderma (an autoimmune disease) symptoms, causes, diagnosis, treatment, facts and prognosis. Scleroderma may be diffuse or limited (CREST variant, in which Raynaud's phenomenon and calcinosis are skin complications). Source:MedicineNet Read 12 more Eosinophilic Fasciitis related articles ... Health Tip: Treating an Ulcer Health Tip: Discussing Death With Children Breast Cancer Tends to Grow Faster in Younger Women Mental Illness Costs U.S. Billions in Lost Earnings Health Highlights: May 8, 2008 Computer Program Helps Drug Abusers Stay Clean TV Coverage of Tragedies Often Lacks Prevention Messages Secret to Treating Tinnitus in Vets May Be Unlocked in Zebrafish Gene Variant Boosts Risk of Severe Diabetic Eye, Kidney Diseases Outside Workers Least Likely to Get Skin Exams