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.
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.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.