Eosinophilic Fasciitis after Covid Infection: A Case Report and Review of Literature

Eosinophilic fasciitis (EF) is a rare fibrosing disorder caused by an autoimmune response to an unknown trigger. Many possible triggers have been suggested including strenuous exercise, drug or chemical exposure, and preceding infection. We present a case of a female patient, age 69 years, who developed EF following SARS-CoV-2 infection. There have been several advances in the diagnosis and management of EF since it was first described 50 years ago. EF is a mimic of scleroderma, but key clinical features can be used to differentiate between the two diagnoses. Laboratory abnormalities include eosinophilia, elevated inflammatory markers, and hypergammaglobulinemia. A full thickness biopsy of the skin including muscle and fascia is recommended to confirm the diagnosis. Imaging modalities such as ultrasound and magnetic resonance imaging have been increasingly used in the diagnosis and follow-up of EF. Corticosteroids remain the first line in treatment of EF. Combination of steroids and methotrexate have shown the best possible outcome. Early diagnosis is important for better treatment response.