Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Eosinophils are a particular type of white blood cells, usually representing a small percentage (less than 8% of the total white blood cell population) that are easily stained by eosin and other dyes; they have a characteristic double-lobed nucleus. 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). Eosinophilic fasciitis is sometimes referred to as Shulman's syndrome.
What is fascia?
The fascia is a sheet or band of fibrous connective tissue under the skin that covers a surface of underlying tissues. Fascia surrounds each of the muscles that move the skeleton. When the fascia is inflamed, the condition is referred to as "fasciitis."
What is eosinophilic fasciitis?
Eosinophilic fasciitis is a rare disease 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.
Common causes of leg swelling include salt retention, cellulitis, congestive heart failure, and medication side effects. Less common causes of leg swelling include blood clots in the leg (thrombosis), parasite infection, lymphedema, liver disease, kidney disease, and diseases that cause thickness of the layers of skin, such as scleroderma and eosinophilic fasciitis. In these diseases, the leg swelling is typically characterized by nonpitting edema.
A skin biopsy is the removal of a piece of skin for the purpose of further examination in the laboratory using a microscope. Skin biopsies are performed to diagnose a number of conditions. Biopsies are not meant t"...