Case Reports
18 September 2023
Vol. 75 No. 3 (2023)
https://doi.org/10.4081/reumatismo.2023.1539

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

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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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Scopus
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Europe PMC
Mazori DR, Femia AN, Vleugels RA. Eosinophilic fasciitis: an updated review on diagnosis and treatment. Curr Rheumatol Rep 2017; 19: 74. DOI: https://doi.org/10.1007/s11926-017-0700-6
Pinal-Fernandez I, Selva-O' Callaghan A, Grau JM. Diagnosis and classification of eosinophilic fasciitis. Autoimmun Rev 2014; 13: 379-82. DOI: https://doi.org/10.1016/j.autrev.2014.01.019
Bischoff L, Derk CT. Eosinophilic fasciitis: demographics, disease pattern and response to treatment: report of 12 cases and review of the literature. Int J Dermatol 2008; 47: 29-35. DOI: https://doi.org/10.1111/j.1365-4632.2007.03544.x
Pinal-Fernandez I, Callejas-Moraga EL, Roade-Tato ML, Simeon-Aznar CP. Groove sign in eosinophilic fasciitis. Lancet 2014; 384: 1774. DOI: https://doi.org/10.1016/S0140-6736(14)60526-2
Jinnin M, Yamamoto T, Asano Y, Ishikawa O, Sato S, Takehara K, et al. Diagnostic criteria, severity classification and guidelines of eosinophilic fasciitis. J Dermatol 2018; 45: 881-90. DOI: https://doi.org/10.1111/1346-8138.14160
Barragan-Martinez C, Speck-Hernandez CA, Montoya-Ortiz G, Mantilla RD, Anaya JM, Rojas-Villarraga A. Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis. PLoS One 2012; 7: e51506. DOI: https://doi.org/10.1371/journal.pone.0051506
Ouchene L, Muntyanu A, Lavoue J, Baron M, Litvinov IV, Netchiporouk E. Toward understanding of environmental risk factors in systemic sclerosis [formula: see text]. J Cutan Med Surg 2021; 25: 188-204. DOI: https://doi.org/10.1177/1203475420957950
Ohtsuka T. Organic solvent-induced myopathy simulating eosinophilic fasciitis and/or dermatomyositis. J Dermatol 2009; 36: 358-9. DOI: https://doi.org/10.1111/j.1346-8138.2009.00653.x
Wang G, Cai P, Ansari GA, Khan MF. Oxidative and nitrosative stress in trichloroethene-mediated autoimmune response. Toxicology 2007; 229: 186-93. DOI: https://doi.org/10.1016/j.tox.2006.10.014
Uzma N, Salar BM, Kumar BS, Aziz N, David MA, Reddy VD. Impact of organic solvents and environmental pollutants on the physiological function in petrol filling workers. Int J Environ Res Public Health 2008; 5: 139-46. DOI: https://doi.org/10.3390/ijerph5030139
Lebeaux D, Frances C, Barete S, Wechsler B, Dubourg O, Renoux J, et al. Eosinophilic fasciitis (Shulman disease): new insights into the therapeutic management from a series of 34 patients. Rheumatology 2012; 51: 557-61. DOI: https://doi.org/10.1093/rheumatology/ker366

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Eosinophilic fasciitis in a young male auto mechanic exposed to organic solvents. (2023). Reumatismo, 75(3). https://doi.org/10.4081/reumatismo.2023.1539
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