Eosinophilic Fasciitis (EF): Symptoms & Treatment

Eosinophilic fasciitis (EF), also known as “Shulman’s syndrome“, refers to a rare syndrome that fascia becomes swollen, inflamed and thick. Fascia is the tissue under the skin and over the muscle.

The syndrome is more common in people aged 30 to 60. The skin of patients on the arms, legs or feet will swell quickly.

The presentation of EF is similar to scleroderma or systemic sclerosis. However, unlike scleroderma, it affects the fascia, not the skin.


Several triggers may relate to EF, such as:

  • strenuous exercise
  • initiation of hemodialysis
  • infection with Borrelia burgdorferi
  • some medications such as: statins, phenytoin, ramipril, subcutaneous heparin.


As it is a rare disease, it is difficult to define its apparent symptoms. Patients usually feel severe pain and swelling.

It can have an ‘orange peel’ like appearance. Less common features are joint pain and carpal tunnel syndrome.

Common treatments include corticosteroids, such as prednisone, and other medications such as hydroxychloroquine. The prognosis is usually good in the case of an early treatment if there is no visceral involvement.

Treatments of EF aiming to eliminate the tissue inflammation, usually use aspirin, and other anti-inflammatory drugs (NSAIDs), as well as cortisone.

Many patients will improve spontaneously. Others can be affected with persistent pain of tissue, in addition to thickening of the involved tissues.

Some researches show that some immune-suppression drugs such as methotrexate, can reduce both the immune inflammation and the need for continued cortisone medications.

Consult your doctors for more details before you take any treatments.

Keywords: Eosinophilic fasciitis; EF; Shulman’s syndrome; fascia.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.