A case of eosinophilic fasciitis

We report a case of eosinophilic fasciitis. A 58-year-old man complained of muscle weakness and stiffness, and joint pain of the limbs for 11 months. Dermatological examination revealed groove sign, which became more prominent when raising the arm. The skin of the forearms and calves was waxy appearance and tight. Muscle weakness and pain were apparent. The laboratory examination showed the absolute eosinophil count was 1.51×109/L in December, 2020, and 0.45 ×109/L in June, 2021. The erythrocyte sedimentation rate was 104 mm/h. Other test results were immunoglobulin G (IgG) 32.7 g/L, C3 0.881 g/L, gamma globulin 36.5%, and the anti-Scl-70 antibody (negative). The histopathology of the lesion on the right forearm was manifested by epidermal atrophy, collagen thickening in the fascia, hyaline degeneration, perivascular infiltration of plasma cells, lymphocytes, and eosinophils, remarkable reduction in elastic fibers in the fascia, and alcian blue stain(+). Patient was diagnosed with eosinophilic fasciitis. The patient refused the treatment with baricitinib and was without follow up.