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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

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.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

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.

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In this Article

• What are eosinophils?
• What is fascia?
• What is eosinophilic fasciitis?
• What causes eosinophilic fasciitis?
• What are symptoms and signs of eosinophilic fasciitis?
• How is eosinophilic fasciitis diagnosed?
• What is the treatment for eosinophilic fasciitis?
• What is the prognosis of eosinophilic fasciitis?
• Can eosinophilic fasciitis be prevented?
• Find a local Rheumatologist in your town
• Eosinophilic Fasciitis Index

The cause of eosinophilic fasciitis is not known. In the 1980s, there was a toxic product in some lots of L-Tryptophan, an over-the-counter sleep aide that was available at the time, which caused illness similar to eosinophilic fasciitis.

The onset of eosinophilic fasciitis sometimes follows exertional exercise activity. Although the cause seems related to an inflammatory response, the agent(s) that trigger the response are not yet identified.

Eosinophilic fasciitis causes inflammation of the tissues beneath the skin as well as sometimes in the skin. This leads to symptoms of swelling, stiffness, warmth, and pain of the involved area. Occasionally, there is discoloration of the skin over the tissues affected and the skin can appear thicker than normal.

The muscle of the involved area can become weakened. Muscle enzyme blood levels can be found to be elevated, particularly and peculiarly, the enzyme aldolase more commonly than the enzyme creatine phosphokinase (CPK).

The diagnosis of eosinophilic fasciitis is made with a skin biopsy of a full thickness of involved deep skin tissue. The biopsy site is usually small, and the doctor numbs the area before the tissue is removed for study by a pathologist, dermatologist, or trained technician. In addition, the thickened fascia can be detected by MRI.