Eosinophilic fasciitis in South Africa. A report of 2 cases.

Eosinophilic fasciitis was first described by Shulman in 1974 and is characterized by oedema of the extremities, peripheral eosinophilia, hypergammaglobulinaemia and inflammation of the deep fascia. The condition has not been previously reported in South Africa. We describe 2 cases seen at the Rheumatology Clinic of the Johannesburg Hospital recently. The most striking clinical features were the marked palmar fascial thickening and oedema of the hands and feet. The latter is said to be uncommon in this syndrome and mimicked the early changes of scleroderma. Furthermore, blood eosinophilia may also occur in scleroderma. Our patients illustrated the extremely variable laboratory features in this disorder. In accordance with previous findings in the literature, visceral involvement was absent in our cases. We suggest that in patients without Raynaud's phenomenon who present with scleroderma-like changes of the distal extremities, a diagnosis of eosinophilic fasciitis should be excluded by a full-thickness biopsy.