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Okuyama S, Satomi H, Ishikawa R, Shishido T, Sato K, Ueki T, Sumi M, Kobayashi H. Eosinophilic Fasciitis with Hypereosinophilia as the Initial Clinical Manifestation of Peripheral T-Cell Lymphoma, Not Otherwise Specified. Intern Med 2022; 61:3425-3429. [PMID: 35491131 PMCID: PMC9751711 DOI: 10.2169/internalmedicine.9300-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A 58-year-old man presented with painful edema of the extremities, and a diagnosis of eosinophilic fasciitis (EF) was confirmed. He also met the criteria for hypereosinophilic syndrome (HES), but there were no findings suggestive of malignancies or hematologic neoplasms despite a close examination. He was started on steroid therapy but subsequently developed severe liver dysfunction, hemophagocytic lymphohistiocytosis, hepatosplenomegaly, and renal involvement. The diagnosis of peripheral T-cell lymphoma, not otherwise specified was finally established by a bone marrow reexamination and liver biopsy. In cases of eosinophilia, EF, and/or HES, it is important to suspect an intrinsic abnormality, including potential T-cell lymphoma.
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Affiliation(s)
- Shuhei Okuyama
- Department of Hematology, Nagano Red Cross Hospital, Japan
| | | | - Ryuto Ishikawa
- Department of Hematology, Nagano Red Cross Hospital, Japan
| | | | - Keijiro Sato
- Department of Hematology, Nagano Red Cross Hospital, Japan
| | | | - Masahiko Sumi
- Department of Hematology, Nagano Red Cross Hospital, Japan
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2
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Grignano E, Mekinian A, Jachiet V, Coppo P, Fain O. Manifestations auto-immunes et inflammatoires des hémopathies lymphoïdes. Rev Med Interne 2017; 38:374-382. [DOI: 10.1016/j.revmed.2016.10.396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 10/03/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
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3
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Bielsa Marsol I. Actualización en la clasificación y el tratamiento de la esclerodermia localizada. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.ad.2012.10.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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4
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Bielsa Marsol I. Update on the classification and treatment of localized scleroderma. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:654-66. [PMID: 23948159 DOI: 10.1016/j.adengl.2012.10.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 10/07/2012] [Indexed: 01/26/2023] Open
Abstract
Morphea or localized scleroderma is a distinctive inflammatory disease that leads to sclerosis of the skin and subcutaneous tissues. It comprises a number of subtypes differentiated according to their clinical presentation and the structure of the skin and underlying tissues involved in the fibrotic process. However, classification is difficult because the boundaries between the different types of morphea are blurred and different entities frequently overlap. The main subtypes are plaque morphea, linear scleroderma, generalized morphea, and pansclerotic morphea. With certain exceptions, the disorder does not have serious systemic repercussions, but it can cause considerable morbidity. In the case of lesions affecting the head, neurological and ocular complications may occur. There is no really effective and universal treatment so it is important to make a correct assessment of the extent and severity of the disease before deciding on a treatment approach.
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Affiliation(s)
- I Bielsa Marsol
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universidad Autónoma de Barcelona, Barcelona, Spain.
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5
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Eosinophilic Fasciitis as a Manifestation of a Cutaneous T-Cell Lymphoma Not Otherwise Specified. Am J Dermatopathol 2013; 35:666-70. [DOI: 10.1097/dad.0b013e3182892230] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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de Masson A, Bouaziz JD, de Latour RP, Benhamou Y, Moluçon-Chabrot C, Bay JO, Laquerrière A, Picquenot JM, Michonneau D, Leguy-Seguin V, Rybojad M, Bonnotte B, Jardin F, Lévesque H, Bagot M, Socié G. Severe aplastic anemia associated with eosinophilic fasciitis: report of 4 cases and review of the literature. Medicine (Baltimore) 2013; 92:69-81. [PMID: 23429351 PMCID: PMC4553982 DOI: 10.1097/md.0b013e3182899e78] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Diffuse eosinophilic fasciitis (Shulman disease) is a rare sclerodermiform syndrome that, in most cases, resolves spontaneously or after corticosteroid therapy. It has been associated with hematologic disorders, such as aplastic anemia. The clinical features and long-term outcomes of patients with eosinophilic fasciitis and associated aplastic anemia have been poorly described. We report the cases of 4 patients with eosinophilic fasciitis and associated severe aplastic anemia. For 3 of these patients, aplastic anemia was refractory to conventional immunosuppressive therapy with antithymocyte globulin and cyclosporine. One of the patients received rituximab as a second-line therapy with significant efficacy for both the skin and hematologic symptoms. To our knowledge, this report is the first to describe rituximab used to treat eosinophilic fasciitis with associated aplastic anemia. In a literature review, we identified 19 additional cases of eosinophilic fasciitis and aplastic anemia. Compared to patients with isolated eosinophilic fasciitis, patients with eosinophilic fasciitis and associated aplastic anemia were more likely to be men (70%) and older (mean age, 56 yr; range, 18-71 yr). Corticosteroid-containing regimens improved skin symptoms in 5 (42%) of 12 cases but were ineffective in the treatment of associated aplastic anemia in all but 1 case. Aplastic anemia was profound in 13 cases (57%) and was the cause of death in 8 cases (35%). Only 5 patients (22%) achieved long-term remission (allogeneic hematopoietic stem cell transplantation: n = 2; cyclosporine-containing regimen: n = 2; high-dose corticosteroid-based regimen: n = 1).
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Affiliation(s)
- Adèle de Masson
- From Université Paris Diderot, Sorbonne Paris Cité; AP-HP; Service de Dermatologie (AdM, JDB, MR, MB) and Service de Greffe de Moëlle et Centre de Référence Maladies Rares des Aplasies Médullaires (RPdL, DM, GS), Hôpital Saint Louis, Paris; Service de Médecine Interne (YB, HL) and Service d’Anatomopathologie (AL), Hôpital Charles-Nicolle, Rouen; Service d’Hématologie (CMC, JOB), Hôpital Estaing, Clermont-Ferrand; Service d’Anatomopathologie (JMP) and Service d’Hématologie (FJ), Centre Henri Becquerel, Rouen; and Service de Médecine Interne et Immunologie Clinique (VLS, BB), Hôpital Le Bocage, Dijon; France
| | - Jean-David Bouaziz
- From Université Paris Diderot, Sorbonne Paris Cité; AP-HP; Service de Dermatologie (AdM, JDB, MR, MB) and Service de Greffe de Moëlle et Centre de Référence Maladies Rares des Aplasies Médullaires (RPdL, DM, GS), Hôpital Saint Louis, Paris; Service de Médecine Interne (YB, HL) and Service d’Anatomopathologie (AL), Hôpital Charles-Nicolle, Rouen; Service d’Hématologie (CMC, JOB), Hôpital Estaing, Clermont-Ferrand; Service d’Anatomopathologie (JMP) and Service d’Hématologie (FJ), Centre Henri Becquerel, Rouen; and Service de Médecine Interne et Immunologie Clinique (VLS, BB), Hôpital Le Bocage, Dijon; France
| | | | | | | | | | | | | | | | | | | | | | | | | | - Martine Bagot
- From Université Paris Diderot, Sorbonne Paris Cité; AP-HP; Service de Dermatologie (AdM, JDB, MR, MB) and Service de Greffe de Moëlle et Centre de Référence Maladies Rares des Aplasies Médullaires (RPdL, DM, GS), Hôpital Saint Louis, Paris; Service de Médecine Interne (YB, HL) and Service d’Anatomopathologie (AL), Hôpital Charles-Nicolle, Rouen; Service d’Hématologie (CMC, JOB), Hôpital Estaing, Clermont-Ferrand; Service d’Anatomopathologie (JMP) and Service d’Hématologie (FJ), Centre Henri Becquerel, Rouen; and Service de Médecine Interne et Immunologie Clinique (VLS, BB), Hôpital Le Bocage, Dijon; France
| | - Gérard Socié
- From Université Paris Diderot, Sorbonne Paris Cité; AP-HP; Service de Dermatologie (AdM, JDB, MR, MB) and Service de Greffe de Moëlle et Centre de Référence Maladies Rares des Aplasies Médullaires (RPdL, DM, GS), Hôpital Saint Louis, Paris; Service de Médecine Interne (YB, HL) and Service d’Anatomopathologie (AL), Hôpital Charles-Nicolle, Rouen; Service d’Hématologie (CMC, JOB), Hôpital Estaing, Clermont-Ferrand; Service d’Anatomopathologie (JMP) and Service d’Hématologie (FJ), Centre Henri Becquerel, Rouen; and Service de Médecine Interne et Immunologie Clinique (VLS, BB), Hôpital Le Bocage, Dijon; France
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7
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Manzini CU, Sebastiani M, Giuggioli D, Manfredi A, Colaci M, Cesinaro AM, Ferri C. D-penicillamine in the treatment of eosinophilic fasciitis: case reports and review of the literature. Clin Rheumatol 2011; 31:183-7. [DOI: 10.1007/s10067-011-1866-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 08/15/2011] [Accepted: 09/24/2011] [Indexed: 10/17/2022]
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8
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Eklund KK, Anttila P, Leirisalo-Repo M. Eosinophilic fasciitis, myositis and arthritis as early manifestations of peripheral T‐cell lymphoma. Scand J Rheumatol 2009; 32:376-7. [PMID: 15080271 DOI: 10.1080/03009740410005061] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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9
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Veyssier-Belot C, Zuech P, Lumbroso-Le Rouic L, Récanati G, Dendale R. Fasciite à éosinophiles révélant l’extension métastatique d’un mélanome de la choroïde : un syndrome paranéoplasique ? Rev Med Interne 2008; 29:1013-6. [DOI: 10.1016/j.revmed.2008.05.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 05/16/2008] [Accepted: 05/22/2008] [Indexed: 11/26/2022]
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10
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Serrano-Grau P, Mascaró-Galy J, Iranzo P. Desarrollo de fascitis eosinofílica tras la ingesta de simvastatina. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s0001-7310(08)74708-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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11
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Serrano-Grau P, Mascaró-Galy J, Iranzo P. Eosinophilic Fasciitis After Taking Simvastatin. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s1578-2190(08)70281-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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12
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Abstract
Deep morphea encompasses a variety of clinical entities in which inflammation and sclerosis are found in the deep dermis, panniculus, fascia, or superficial muscle. Morphea profunda, eosinophilic fasciitis, and disabling pansclerotic morphea of children are included in this group, but overlapping of the extent and depth of cutaneous involvement in these various conditions precludes their distinction on the sole basis of clinical or even histologic examination. Furthermore, the limits between morphea profunda and generalized morphea, which usually are classified outside this group, are not clear. Histologically, all these disorders show similar inflammatory and sclerotic findings, the primary difference being the depth of these changes. Associated clinical findings, including arthralgias, arthritis, contractures, or carpal tunnel syndrome, are frequent. Although visceral complications are uncommon, pulmonary, esophageal, and even cardiac abnormalities have been reported. Eosinophilia, hypergammaglobulinemia, and increased erythrocyte sedimentation rate may be present with disease activity. Laboratory studies may demonstrate autoantibody production. Treatment is nonstandardized but UVA irradiation and antiinflammatory or immunosuppressive drugs (mainly antimalarial agents and corticosteroids) may be beneficial.
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Affiliation(s)
- Isabel Bielsa
- Department of Dermatology, Hospital Germans Trias i Pujol, Autonomous University of Barcelona, Badalona, Barcelona, Spain.
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13
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Affiliation(s)
- F Ballanger
- Clinique Dermatologique, CHU Hôtel Dieu, 44093 Nantes Cedex 01
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14
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DeGiovanni C, Chard M, Woollons A. Eosinophilic fasciitis secondary to treatment with atorvastatin. Clin Exp Dermatol 2006; 31:131-2. [PMID: 16309506 DOI: 10.1111/j.1365-2230.2005.01975.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Abstract
Scleroderma is characterized by major clinical symptoms, but a number of unrelated disease may mimic these features more or less completely. Even scleroderma itself sometimes presents in an unusual manner. This article deals with uncommon presentations of true scleroderma and its variants and pseudo -scleroderma diseases.
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Affiliation(s)
- Uwe-Frithjof Haustein
- Department of Dermatology, Venerology and Allergology, University of Leipzig, D-04103 Leipzig, Germany.
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16
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Chakravarty EF, Genovese MC. Associations between rheumatoid arthritis and malignancy. Rheum Dis Clin North Am 2004; 30:271-84, vi. [PMID: 15172040 DOI: 10.1016/j.rdc.2004.01.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There are many complex associations between rheumatoid arthritis(RA) and malignancy. Patients with rheumatic diseases on the whole appear to be at increased risk for the development of certain malignancies. The data from several studies are persuasive that the presence of RA conveys an increased risk for the development of lymphoproliferative disorders and may convey a decreased risk for the development of malignancies of the digestive tract. Understanding the complex interrelationships between RA and malignancy will lead to more accurate diagnosis of underlying pathology, more effective treatment of symptoms and underlying disease, and appropriate surveillance for the development of later complications.
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Affiliation(s)
- Eliza F Chakravarty
- Division of Immunology and Rheumatology, Stanford University School of Medicine, 1000 Welch Road, #203, Palo Alto, CA 94303, USA
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17
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Abstract
The relation between rheumatic syndromes and an underlying malignancy is a complex one. As a result of autoimmunity, an aberrant immune response, or the use of immunomodulatory drugs, many of the rheumatic diseases appear to pose an increased risk for the development of malignancy. Unfortunately, for many of the same reasons, the presence of an underlying malignancy can result in the development of features of rheumatic disease. Awareness of the associations between rheumatic syndromes and malignancy will aid the clinician in the accurate diagnosis of underlying pathology, more effective treatment of both the symptoms and underlying disease, and appropriate surveillance for the development of later complications.
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18
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Abstract
Several distinct entities associated with dermal fibrosis can mimic scleroderma/systemic sclerosis. The list of scleroderma-like conditions or scleroderma variants includes eosinophilic fasciitis, localized forms of scleroderma, scleredema and scleromyxedema, keloids, and environmental exposure-associated conditions including eosinophilia-myalgia syndrome and pseudosclerodermas induced by various drugs. Although these conditions are relatively uncommon, their accurate recognition is essential to avoid misdiagnosis and inappropriate therapy. The pathogenesis of these scleroderma variants appears to share similarities with each other and with that of scleroderma. Better understanding of scleroderma-like disorders is emerging through epidemiologic investigations, and in vivo and in vitro experimental research. Activation of eosinophils and disordered regulation of fibroblast collagen synthesis, apoptosis, and proliferation are recurrent findings in these disorders. The etiologic role of infection with Borrelia species or other microorganisms remains controversial. Cytokines such as transforming growth factor-beta, interleukin-4, interleukin-13, and connective tissue growth factor contribute to fibrosis in these disorders by inducing an accentuated and persistent fibrogenic response to tissue injury. The role of genetic factors in susceptibility and clinical expression of scleroderma-like conditions remains to be systematically addressed. Because of the relative rarity of these conditions, few well-controlled clinical treatment trials have been performed. In addition, there is no consensus on optimal management. Much anecdotal information and small clinical series indicate that phototherapy may have a role in the treatment of scleroderma-like conditions.
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Affiliation(s)
- Yasuji Mori
- Section of Rheumatology, University of Illinois at Chicago College of Medicine, 1158 MBRB, 900 S. Ashland Avenue, Chicago, IL 60607-7171, USA.
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19
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Peña Somovilla JL, Zabalza Azparren M, Blanco Ramos JR, Del Cura Ortiz E. [Peripheral eosinophilia and cutenous lesions]. Rev Clin Esp 2002; 202:119-20. [PMID: 11996770 DOI: 10.1016/s0014-2565(02)71000-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J L Peña Somovilla
- Servicios de Medicina Interna, Complejo Hospitalario San Millán-San Pedro, Logroño, Spain
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