Eosinophilic fasciitis, also called Shulman's syndrome, is a disorder in which the muscle tissue under skin, which is called fascia, becomes swollen and thick. It usually occurs most notably in the arms and legs, but it can spread to other parts of the body. It is a rare condition; only 250 cases were reported between 1974 and 2009.
Early symptoms of eosinophilic fasciitis can include pain and swelling, usually on the inside of the arms and in the front of the legs. Swelling may also spread do the chest and stomach areas and sometimes even the face. These symptoms are usually first noticed after any strenuous activity.
As the eosinophilic fasciitis progresses, the swelling is accompanied by a general hardening of the skin, which will usually begin to take on a texture similar to an orange peel. The person's arms and legs then become very stiff and harden, making them nearly impossible to move. In some cases they may even become stuck in uncomfortable positions.
As the muscles continue to swell, they will become fatigued and weaken. Bone pain as well as pain and numbness in the hands are both common symptoms of eosinophilic fasciitis. In some cases, the condition can cause a drop in the number of red blood cells, which leads to fatigue and the tendency to bleed easily.
Although eosinophilic fasciitis is rare, it does not share symptoms with many other conditions. A doctor will usually be able to make a diagnosis based on a physical examination and a biopsy of the affected skin and tissue. In some cases, an MRI may be done if a biopsy is not conclusive.
Treatment for eosinophilic fasciitis usually includes corticosteroids. Early treatment can help reduce the chances of tissue loss and scarring. Any skin damage or atrophy caused by the condition cannot be reversed. Inflammations caused by the condition do not go away quickly, and treatment may sometimes last as long as five years. Regular check-ups are recommended even after the symptoms have subsided, as the condition is known to be recurring.
Unlike other forms of eosinophilia, which are usually caused by allergic reactions or parasites, there is no known cause for eosinophilic fasciitis. It is most common in Caucasian males aged 30 to 40. There is little information on the mortality rate of the condition because it is so rare, although it is not believed to be fatal.