Eosinophilic fasciitis occurring four weeks after the onset of dialysis in a renal failure patient.
BACKGROUND
Eosinophilic fasciitis is a rare, scleroderma-like disease that usually affects the extremities of young to middle-aged males. The disease may cause flexion contractures and limit joint mobility and is associated with peripheral eosinophilia. The fascia, by definition, is infiltrated with mononuclear cells and typically with eosinophils. Eosinophilic fasciitis may be separated from another sclerodermatous disorder, linear scleroderma, by its response to systemic corticosteroids. The etiology is unclear but eosinophilic fasciitis has numerous disease associations. However, it has not previously been associated with renal failure and hemodialysis.


OBJECTIVE
This article reports a case of eosinophilic fasciitis occurring four weeks following the onset of hemodialysis.


METHODS
The clinical and histologic features confirmed the diagnosis of eosinophilic fasciitis. He was treated with systemic corticosteroids with good response.


CONCLUSIONS
This is the first reported patient who developed eosinophilic fasciitis in close temporal relationship with the start of hemodialysis. While eosinophilic fasciitis may be coincidental with a common disorder, namely, renal failure, it is interesting to note that hemodialysis patients often have immune-regulation abnormalities and peripheral eosinophilia.
Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City 84132, USA. scott@derm.med.utah.edu
S R
SR
Florell
C A
CA
Egan
M C
MC
Gregory
J J
JJ
Zone
M J
MJ
Petersen
D000368:Aged; D004802:Eosinophilia / Q000150:complications* / Q000276:immunology; D005208:Fasciitis / Q000150:complications* / Q000276:immunology; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications / Q000276:immunology / Q000628:therapy*; D013997:Time Factors