| Autor: |
Treichel AM; Department of Dermatology, Cleveland Medical Center University Hospital, Case Western Reserve University, Cleveland, Ohio. treichelalison@gmal.com., Zheng DX; Department of Dermatology, Cleveland Medical Center University Hospital, Case Western Reserve University, Cleveland, Ohio. dxz281@case.edu., Ranasinghe GC; Department of Dermatology, Cleveland Clinic, Ohio. ranasig@ccf.org., Zeft AS; Division of Pediatric Rheumatology, Department of Pediatrics, Cleveland Clinic, Ohio. zefta@ccf.org., Bergfeld WF; Department of Dermatology, Cleveland Clinic, Ohio. bergfew@ccf.org., Bayart CB; Department of Pediatric Dermatology, Cincinnati Children's Hospital Medical Center, Ohio. cheryl.bayart@cchmc.org. |
| Abstrakt: |
We report a case of eosinophilic fasciitis in a teenage auto mechanic who was most likely affected by occupational exposure to organic solvents, including the aromatic hydrocarbons benzene, trimethylbenzene, naphthalene, toluene, and xylene. The patient presented with an 8-month history of painful induration of his extremities and an abnormal gait. A deep excisional biopsy of the fascia was obtained, demonstrating subcutaneous fibrosis with perivascular and interstitial inflammation, with lymphocytes and plasma cells spilling into the sclerosed fascia, and focal fibrinoid necrosis. Treatment was begun with intravenous pulse doses of methylprednisolone, prednisone (20 mg daily), and subcutaneous methotrexate (25 mg weekly), and the patient's painful induration had resolved and gait had normalized at the 6-month follow-up. Our case suggests that exposure to organic solvents could be implicated in the pathogenesis of eosinophilic fasciitis and highlights the importance of a thorough occupational history to prevent repeat exposures to potentially causative agents. |
