https://doi.org/10.4081/reumatismo.2023.1539

Eosinophilic fasciitis in a young male auto mechanic exposed to organic solvents

Vol. 75 No. 3 (2023)
Submitted: 1 December 2022
Accepted: 8 July 2023
Published: 18 September 2023
Aromatic hydrocarbons, eosinophilic fasciitis, occupational exposure, solvents, systemic sclerosis
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Authors

A.M. Treichel
Department of Dermatology, Cleveland Medical Center University Hospital, Case Western Reserve University, Cleveland, Ohio, United States.
D.X. Zheng
Department of Dermatology, Cleveland Medical Center University Hospital, Case Western Reserve University, Cleveland, Ohio, United States.
G.C. Ranasinghe
Department of Dermatology, Cleveland Clinic, Ohio, United States.
A.S. Zeft
zefta@ccf.org
Division of Pediatric Rheumatology, Department of Pediatrics, Cleveland Clinic, Ohio, United States.
W.F. Bergfeld
Department of Dermatology, Cleveland Clinic, Ohio, United States.
C.B. Bayart
Department of Pediatric Dermatology, Cincinnati Children’s Hospital Medical Center, Ohio, United States.

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.

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How to Cite

Treichel, A., Zheng, D., Ranasinghe, G., Zeft, A., Bergfeld, W., & Bayart, C. (2023). Eosinophilic fasciitis in a young male auto mechanic exposed to organic solvents. Reumatismo, 75(3). https://doi.org/10.4081/reumatismo.2023.1539
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