Eosinophilic fasciitis pathology

Histology of eosinophilic fasciitis

The scanning power view of eosinophilic fasciitis shows a sclerosing process that affects depth subcutaneous tissue and fascia (Figure 1). In early disease there is edema of the fascia and subcutaneous tissue with a lymphocytic infiltrate containing plasma cells and eosinophils. Over time collagen it thickens and sclerotic (Figure 2) with extension towards the subcutaneous fibrous septa. Lobular involvement is rare. Tissue eosinophils can be focal around attached structures or diffuse within the tissue infiltrate (Figure 3). In more involved cases, changes can extend to dermis. the epidermis normally not involved, albeit mild atrophy It can be seen in a minority of cases.

Differential diagnosis eosinophilic fasciitis

Scleroderma: Involvement of the epidermis and upper dermis is rare in eosinophilic fasciitis, particularly in early lesions. A significant number of eosinophils in the infiltrate would not favor scleroderma.

Arthropod bite reaction: although a deep eosinophilic infiltrate may be seen, the extension to and beyond the subcutaneous tissue is atypical. The presence of superficial epidermal and dermal the changes would argue against eosinophilic fasciitis.

Proliferative fasciitis: in addition to fascial fibrosis there are great ganglion like cells and a pauci-inflammatory myxoid stroma.