title: A case of eosinophilic fasciitis presenting as pitting edema of the lower extremities.
abstract: Eosinophilic fasciitis is a rare disease characterized by diffuse fasciitis with peripheral eosinophilia and progressive induration and thickening of the skin and soft tissues. We report a 19-year-old female who presented with pitting edema in both lower extremities. She had a history of excessive physical activity before her symptoms developed. Physical examination revealed 2+ pitting edema in both lower legs. She complained of mild pain in both knee joints and feet, with no tenderness or heating sensations. Laboratory results were unremarkable except for severe eosinophilia. Parasite infection, venous thrombosis, and cardiac and renal problems were excluded. A magnetic resonance imaging study of both lower extremities revealed increased signal intensity in the subcutaneous lesions, consistent with superficial inflammation of the fascia. Mixed perivenular lymphoplasmacytic and eosinophilic infiltration in the subcutaneous lesion were observed on biopsy. The patient was treated with corticosteroids, resulting in remarkable improvement in both edema and eosinophilia.
authors.affiliation: Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hee Seon
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Chang
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Myung Suk
authors.initials: MS
authors.lastname: Kang
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Choon Sik
authors.initials: CS
authors.lastname: Yoon
authors.affiliation: Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Myung Hyun
authors.initials: MH
authors.lastname: Sohn
authors.affiliation: Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyu-Earn
authors.initials: KE
authors.lastname: Kim
keywords: Eosinophilia; eosinophilic fasciitis; pitting edema