Oluwakemi Onajin1, Carilyn N Wieland2, Margot S Peters2, Christine M Lohse3, Julia S Lehman4. 1. Department of Dermatology, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota. 2. Department of Dermatology, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota; Department of Laboratory Medicine and Pathology, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota. 3. Division of Biomedical Statistics and Informatics, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota. 4. Department of Dermatology, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota; Department of Laboratory Medicine and Pathology, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota. Electronic address: lehman.julia@mayo.edu.
Abstract
BACKGROUND: Eosinophilic fasciitis (EF) and morphea profunda (MP) are inflammatory and sclerosing disorders of the subcutis that can exhibit clinical and pathologic presentations that overlap. OBJECTIVE: To identify clinicopathologic features that can be used to distinguish EF from MP. METHODS: We performed a retrospective review of 16 patients with EF and 11 patients with MP. Hematoxylin-eosin, CD123, CD34, and Verhoeff-Van Gieson stains were evaluated on skin biopsies that included the fascia. RESULTS: EF patients were more likely than MP patients to be men (P = .047), have forearm involvement (P = .003), and have peripheral eosinophilia (P < .01). Compared with MP patients, patients with EF were more likely to have fascia that contained eosinophils (P = .003), although eosinophils were absent in 3 (19%) patients with EF. Focal absence of CD34 staining was more prominent in the fascia of EF patients (P = .04). The extent of Verhoeff-Van Gieson staining did not differ between the 2 groups. Dermal sclerosis was not detected in many cases of EF and MP (56% and 36%, respectively). LIMITATIONS: This was a retrospective study at a single institution. CONCLUSION: Although EF and MP share clinical and pathologic features, our results indicate that the presence of eosinophils in the blood and fascia and focal loss of CD34 staining might be more suggestive of EF than MP.
BACKGROUND:Eosinophilic fasciitis (EF) and morphea profunda (MP) are inflammatory and sclerosing disorders of the subcutis that can exhibit clinical and pathologic presentations that overlap. OBJECTIVE: To identify clinicopathologic features that can be used to distinguish EF from MP. METHODS: We performed a retrospective review of 16 patients with EF and 11 patients with MP. Hematoxylin-eosin, CD123, CD34, and Verhoeff-Van Gieson stains were evaluated on skin biopsies that included the fascia. RESULTS: EF patients were more likely than MP patients to be men (P = .047), have forearm involvement (P = .003), and have peripheral eosinophilia (P < .01). Compared with MP patients, patients with EF were more likely to have fascia that contained eosinophils (P = .003), although eosinophils were absent in 3 (19%) patients with EF. Focal absence of CD34 staining was more prominent in the fascia of EF patients (P = .04). The extent of Verhoeff-Van Gieson staining did not differ between the 2 groups. Dermal sclerosis was not detected in many cases of EF and MP (56% and 36%, respectively). LIMITATIONS: This was a retrospective study at a single institution. CONCLUSION: Although EF and MP share clinical and pathologic features, our results indicate that the presence of eosinophils in the blood and fascia and focal loss of CD34 staining might be more suggestive of EF than MP.
Authors: Maria Ester Simeira Fonseca; Maria Victória Quaresma; Ana Paula Luppino-Assad; Henrique Carriço da Silva; Danieli Castro O Andrade; Percival D Sampaio-Barros Journal: Rheumatol Int Date: 2017-12-15 Impact factor: 2.631
Authors: Aaron R Mangold; Collin M Costello; Helen J L Cumsky; David J DiCaudo; W Leroy Griffing; Mark R Pittelkow Journal: JAAD Case Rep Date: 2018-09-14