Eosinophilic fasciitis: clinical characteristics and response to methotrexate

Aim To describe our experience with 16 patients with eosinophilic fasciitis ( EF ) treated in our clinic over 14 years. Methods We retrospectively reviewed the charts of all patients with biopsy‐proven EF . We collected data regarding demographics, clinical presentations, possible triggers, labs, imaging, treatment and response to therapy on follow‐up. Results Eight women and eight men with a mean age of 52 years were included in the study. Three patients related the onset to prior strenuous exercise and one was exposed to vibratory machinery. Fourteen patients had a gradual onset and presented with induration of the skin. Two other patients presented with acute‐onset and significant edema and weight gain. All patients required immunosuppressive therapy. Methotrexate ( MTX ) was used in all of our patients. The rate of complete remission was ~60%. Although the recurrence rate after stopping MTX was 70%, these patients responded well to re‐treatment with MTX . Conclusion We believe that MTX represents an effective treatment option for EF . The rarity of this disease would make a double‐blind controlled trial study difficult to perform.