Clinical treatment of eosinophilic fasciitis: a case report
1例嗜酸性筋膜炎患者临床用药治疗的分析

摘要

嗜酸性筋膜炎是指一种累及肢体皮肤深筋膜而有硬皮病样表现的结缔组织疾病，又被称为嗜酸性粒细胞增多的弥漫性筋膜炎、舒尔曼综合征等。主要的临床表现为：急性发病、患者大多数具有过度劳累的病史，出现对称性的皮肤肿胀，肿痛以及僵硬，常发于四肢，可累及其他部位。一般情况下患者常出现关节疼痛、关节挛缩等症状[1-2]。实验室检查显示：外周血嗜酸性粒细胞增高，高Y球蛋白血症。沟槽征是嗜酸性筋膜炎的一个经典特征，可观察到沿浅静脉的凹陷，肢体抬高时最明显。嗜酸性筋膜炎少见，导致诊疗上的延误。嗜酸性筋膜炎典型特征沟槽征的识别，有助于诊断[3-4]。在诊断过程种的主要依据为：发病前常有过度劳累史；急性发病；硬皮病样皮肤损害；末梢血嗜酸粒细胞显著增高；皮肤组织病理示深筋膜炎症伴嗜酸性粒细胞浸润，而表皮、真皮无明显改变[5-6]。

Abstract

Eosinophilic fasciitis refers to a connective tissue disease involving the deep fascia of the skin of limbs with scleroderma, also known as diffuse fasciitis of eosinophilic increase, Schulman's syndrome, etc. The main clinical manifestations are: acute onset, most patients have a history of overwork, and symmetrical skin swelling, swelling, pain, and stiffness, often in the limbs but involving other parts of the body. In general, patients often have joint pain, joint contracture and other symptoms[1-2]. Laboratory tests revealed peripheral eosinophilia and hypery-globulinemia. A classic feature of eosinophilic fasciitis is the groove sign, which is observed along the superficial veins and is most pronounced when the limb is elevated. Eosinophilic fasciitis is rare and causes delays in diagnosis and treatment. Identification of groove sign, a typical feature of eosinophilic fasciitis, is helpful for diagnosis[3-4]. In the diagnosis process, the main basis is: the history of overwork before the onset; Acute onset; Scleroderma-like skin lesions; Eosinophils in peripheral blood increased significantly. Skin histopathology showed deep fascial inflammation accompanied by eosinophil infiltration, while there were no significant changes in epidermis and dermis[5-6].