Keywords
COVID-19
post-infectious immune-mediated disease
case report
Categories
How to Cite
Abstract
Background: Eosinophilic fasciitis is a rare scleroderma-like disorder characterized by inflammation and thickening of the fascia, typically presenting with skin induration, peripheral eosinophilia, and absence of systemic organ involvement. Its etiology remains unclear, although immune-mediated mechanisms and various triggers have been proposed. Case presentation: We report a case of a 49-year-old woman who developed progressive pain, stiffness, and skin induration of the upper extremities shortly after COVID-19 infection. Laboratory evaluation revealed eosinophilia, acute phase reactants and negative autoimmune serology. Magnetic resonance imaging demonstrated fascial involvement without muscle pathology. Histopathological examination confirmed eosinophilic fasciitis, showing inflammatory infiltrates and fibrosis within the fascia. The patient was treated with high-dose glucocorticoids and steroid-sparing agent – methotrexate, with subsequent clinical and laboratory improvement. At follow-up, complete resolution of symptoms was observed, reaching drug-free remission after approximately 18 months. Conclusion: This case highlights eosinophilic fasciitis as a potential post-infectious immune-mediated condition following COVID-19. Early recognition, appropriate imaging, and confirmatory biopsy are essential for timely diagnosis, appropriate treatment and favorable outcomes.
References
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Copyright (c) 2026 Miroslav Markov, Maria Kosturkova, Maria Dimova, Vladislav Velikov (Author)