Eosinophilic fasciitis is an uncommon disorder and its diagnosis may be a challenge for someone who is unfamiliar with it.
Clinical features:
(1) edema and pain in the extremities
(2) thickening of the skin with induration and "peau d'orange"
(3) skin hyperpigmentation
Laboratory findings:
(1) eosinophilia in the peripheral blood differential count
(2) polyclonal hypergammaglobulinemia
(3) increase in acute phase reactants
MRI findings:
(1) increased signal intensity within fascia
(2) gandolinium enhancement in fascia
Histologic findings in fascia (requires a deep biopsy):
(1) fibrous thickening of the fascia
(2) eosinophilic infiltrate
Differential diagnosis:
(1) scleroderma
(2) parasitic infection
(3) IgG4-related disease
(4) peripheral T-cell lymphoma
(5) toxic exposures
