title: Eosinophilic fasciitis: report of two cases and a systematic review of the literature dealing with clinical variables that predict outcome.
abstract: We reported two patients with refractory eosinophilic fasciitis (EF) and provided a systematic review of the literature to determine the clinical variables associated with prognosis of EF. We enrolled 88 cases, whose clinical characteristics were analyzed by separating the patients into two or three groups based on outcome. The incidence of certain clinical and pathological features differed among the groups. In particular, the incidence of morphea-like skin lesions in patients with refractory fibrosis was significantly higher than in patients without refractory fibrosis (p = 0.003). Patients with morphea-like skin lesions were 1.9 times more likely to develop persistent fibrosis than patients without these lesions (95% confidence intervals, 1.5-2.5). A younger age (under 12 years) at onset was associated with a 1.6 times greater risk of residual fibrosis (95% confidence interval, 1.1-2.2). Trunk involvement was associated with a 1.4 times greater risk of residual fibrosis (95% confidence interval, 1.0-2.0). Histopathologically, the presence of dermal fibrosclerosis was associated with a 1.4 times greater risk of refractory fibrosis (95% confidence interval, 1.0-2.1). We consider these clinical characteristics, notably the presence of morphea-like skin lesions may be an important risk factor for developing residual fibrosis in EF patients.
authors.affiliation: Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. y_endou@bishinkai.or.jp
authors.forename: Yukie
authors.initials: Y
authors.lastname: Endo
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tamura
authors.forename: Youichiro
authors.initials: Y
authors.lastname: Matsushima
authors.forename: Tomoko
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Michiko
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Nagai
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004802:Eosinophilia / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D005208:Fasciitis / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D011379:Prognosis; D012074:Remission Induction; D012594:Scleroderma, Localized / Q000097:blood / Q000150:complications* / Q000276:immunology; D013256:Steroids / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D013256:Steroids