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. 2019 Oct 15;25(2):140–149. doi: 10.1634/theoncologist.2019-0508

Table 2.

Laboratory, imaging, histopathology results, and therapy

Patient no. Reference Presentation and physical exam findings CK, U/L Peak absolute eosinophil count, per μL Imaging Biopsy Treatment
1 Current paper Elbows, wrists, knees, ankles, with tightness, swelling, reduced wrist range of motion, and a positive groove sign in the left leg and right forearm 933 3,500 MRI left tibia: very mild edema seen diffusely within the fascia Full‐thickness skin biopsy: striking expansion of the fascia by connective tissue matrix comprising collagen and mucin. Superficial inflammatory cell infiltrate permeating the fascia comprising lymphocytes and plasma cells. CD3 staining demonstrates presence of T lymphocytes, CD8+ T cells predominate Prednisone 60 mg/day, methotrexate 20 mg/week
2 Current paper Pitting edema of hands and feet, myalgias; subsequent skin tightness of the forearms <20 2,400 None performed Full‐thickness skin biopsy: fibrosing stromal changes; subcutaneous, fascia, and skeletal muscle infiltration by plasma cell–rich inflammatory infiltrate with eosinophils; CD3+ staining demonstrates presence of T lymphocytes; CD4+ T cells predominate Prednisone 60 mg/day, methotrexate 15 mg/week
3 Current paper Swelling of volar aspect of forearms; limited knee range of motion 104 700 MRI right forearm: edema within the fascial planes of the extensor palmar compartments, muscle signal relatively maintained; mild wrist extensor and flexor tenosynovitis None performed Prednisone 80 mg/day, mycophenolate 3 g/day
4 Current paper Fatigue, weight loss, extremity swelling initially; leathery texture of arms and legs; positive groove sign; reduced range of motion in fingers, wrists, elbows, shoulders, knees, and ankles 2,300 MRI pelvis: fascial edema in pelvis and proximal thighs, extensive soft tissue edema and proximal abductor muscles bilaterally None performed Prednisone 80 mg/day, methotrexate 15 mg/week
5 Khoja et al., 2016 Myalgia, puffiness of the face; thickened and tethered waxy skin on all limbs and abdomen 28 5,240 MRI right upper limb: marked fascial edema associated with the musculature of the arm, right chest wall involving the latissimus dorsi, serratus anterior, and pectoralis Full‐thickness skin biopsy: infiltration of dermis with a lymphoeosinophilic infiltrate with scattered eosinophils in the interstitium Methylprednisolone 1 g/day (for treatment of coincident presumed CNS vasculitis)
6 Lidar et al., 2018 Not reported Not reported Not reported PET/CT: increased uptake in soft tissues in legs Muscle biopsy: eosinophilic fasciitis Corticosteroid and methotrexate
7 Andrés‐Lencina et al., 2018 Brownish‐red plaque with significant induration and tethered waxy skin on the pubis that extended to the left anterior iliac crest region Not reported 4,000 None performed Full‐thickness skin biopsy: dermal fibrosis with dense hyalinized collagen, extending to the subcutis and fascia. Lymphocytic perivascular infiltration was also observed, with eosinophils that deepened to fascia Prednisone 100 mg/day; methotrexate 20 mg/week (cyclosporine ineffective)
8 Le Tallec et al., 2019 Myalgia, diffuse skin thickening of arms and legs WNL 4,140 MRI left thigh: abnormal linear high signal along the fasciae Muscle biopsy: marked CD8‐positive inflammatory infiltrate of the fasciae coexisting with eosinophils with an anecdotic muscle involvement, thus ruling out other diagnoses such as myositis Corticosteroid and methotrexate
9 Toussaint et al., 2019 Myalgia, extremity edema; woody induration, peau d'orange, positive groove sign bilateral forearms 227 4,092 MRI bilateral forearms: superficial and deep fascial thickening, thickened skin, and intra‐/subcutaneous edema None performed Prednisone 1 mg/kg/day, methotrexate
10 Rischin et al., 2018 Diffuse arthralgia and myalgia; forearms and hands with skin tightness and forearm induration, severe limitation of finger movement WNL 600 MRI forearm: fasciitis surrounding all muscle compartments with no myositis Left forearm biopsy: florid lymphocytic fasciitis composed of predominantly T cells and macrophages, with scattered plasma cells and perivascular cuffing by lymphocytes in the deep subcutaneous tissue and underlying fascia; CD3+ staining demonstrates presence of T lymphocytes Prednisolone 50 mg/day, methotrexate 20 mg/week
11 Parker et al., 2018 Fatigue and myalgia; proximal muscle weakness; woody feel to skin of forearms, contracture of the left forearm flexor 75 WNL MRI: symmetric fascial thickening and intense STIR signal centered around the muscle fascia of all thigh and calf muscle groups Full‐thickness skin‐muscle biopsy: fascial and perifascicular inflammatory infiltrate with CD3+ cells; majority of myofibers showed HLA Class‐I immunolabelling Prednisolone 30 mg/day, IVIg
12 Daoussis et al., 2017 Swelling of wrists, knees, ankles, profound crepitus in all involved areas Not reported Not reported MRI knee and ankle: symmetric myofasciitis with associated tenosynovitis None performed Methylprednisolone 12 mg/day
13 Narvaez et al., 2018 Both patients (patients 13 and 14) are described as having proximal symmetric leg weakness and stiffening of the skin of the lower extremities Not reported Not reported MRI lower extremities: focal changes of myositis and fasciitis of the right gastrocnemius and soleus; subcutaneous edematous changes None performed NSAIDs and colchicine; drug withdrawal
14 Narvaez et al., 2018 Not reported Not reported MRI lower extremities: extensive changes of myositis and less marked changes of fasciitis involving the adductor muscles None performed Drug withdrawal
15 Bronstein et al., 2011 Clinically silent WNL Not reported PET/CT: FDG‐avid abdominal fasciitis None performed Not reported

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Abbreviations: CK, creatine kinase; CNS, central nervous system; FDG, fluorodeoxyglucose; IVIg, intravenous immunoglobulin; MRI, magnetic resonance imaging; NSAIDs, nonsteroidal anti‐inflammatory drugs; PET/CT, positron emission tomography/computed tomography; STIR, short tau inversion recovery; WNL, within normal limits.