嗜酸性筋膜炎——三例报告及文献综述
Eosinophilic Fasciitis - Report of Three Cases and Review of the Literature.
作者信息
Wollina Uwe, Hansel Gesina, Schönlebe Jacqueline, Heinig Birgit, Temelkova Ivanka, Tchernev Georgi, Vojvocic Aleksandra, Lotti Torello
机构信息
Städtisches Klinikum Dresden, Department of Dermatology and Allergology, Dresden, Germany.
Institute of Pathology "Georg Schmorl", Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.
出版信息
Open Access Maced J Med Sci. 2019 May 15;7(18):2964-2968. doi: 10.3889/oamjms.2019.296. eCollection 2019 Sep 30.
BACKGROUND
Eosinophilic fasciitis is a rare fibrosing disorder of muscle fascia with rapid onset of erythema, induration, oedema and tenderness affecting extremities bilaterally.
CASE REPORT
We report three cases of eosinophilic fasciitis in 3 females aged 64, 65 and 73 years, in two of them in association with morphea. They fulfilled the proposed diagnostic criteria. Associated malignancies could be excluded in all of them. They were treated by systemic corticosteroids. In the two females with associated morphea higher prednisolone dosages and a combination with methotrexate was necessary.
CONCLUSIONS
Eosinophilic fasciitis is a differential diagnosis of systemic scleroderma. Response to treatment is often delayed. Systemic corticosteroids are the first line therapy. Patients with associated morphea need combined drug therapy, in our patients with methotrexate. There is no close correlation between laboratory signs of inflammation and clinical response to treatment.
背景
嗜酸性筋膜炎是一种罕见的肌肉筋膜纤维化疾病，起病迅速，表现为双侧肢体出现红斑、硬结、水肿和压痛。
病例报告
我们报告了3例嗜酸性筋膜炎病例，患者为3名女性，年龄分别为64岁、65岁和73岁，其中2例与硬斑病相关。她们均符合拟定的诊断标准。所有患者均排除了相关恶性肿瘤。她们接受了全身性皮质类固醇治疗。在2例合并硬斑病的女性患者中，需要更高剂量的泼尼松龙并联合甲氨蝶呤治疗。
结论
嗜酸性筋膜炎是系统性硬化症的鉴别诊断之一。治疗反应通常延迟。全身性皮质类固醇是一线治疗方法。合并硬斑病的患者需要联合药物治疗，在我们的患者中联合了甲氨蝶呤。炎症的实验室指标与治疗的临床反应之间没有密切相关性。
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