{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:59:38Z","timestamp":1785167978569,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Eosinophilic fasciitis (EF) is a rare connective tissue disorder characterized by symmetrical or asymmetrical skin induration, fascial inflammation, and peripheral eosinophilia. We report the case of a middle-aged man presenting with left knee pain and swelling, progressive skin induration and pigmentation changes on the thigh and trunk. Blood workup showed peripheral eosinophilia and weakly positive PM-Scl-100 antibodies. MRI demonstrated fascial thickening with subcutaneous edema and fluid tracking along fascial planes, as well as a moderate knee effusion. Muscle biopsy confirmed eosinophilic fasciitis without muscle involvement. He was treated with high-dose prednisolone, methotrexate as a steroid-sparing agent, and adjunctive bone and infection prophylaxis, with marked clinical improvement at follow-up.<\/jats:p>\n                  <jats:p>This case highlights the diagnostic challenges in atypical presentation of eosinophilic fasciitis in the presence of overlap autoantibodies. Careful clinicopathological correlation is critical to exclude other differentials as EF can mimic systemic sclerosis or myositis. Biopsy can improve diagnostic certainty particularly when encountering auto-antibodies that have some association with other diagnoses.<\/jats:p>","DOI":"10.3389\/fmed.2026.1870461","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:08:26Z","timestamp":1785164906000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Eosinophilic fasciitis with PM-Scl antibody positivity: expanding the serological spectrum"],"prefix":"10.3389","volume":"13","author":[{"given":"Alvina","family":"Zanib","sequence":"first","affiliation":[{"name":"School of Medicine, University of Limerick","place":["Limerick, Ireland"]},{"name":"Infectious Disease Department, Health Service Executive Mid West","place":["Limerick, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Manicom","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Limerick","place":["Limerick, Ireland"]},{"name":"Infectious Disease Department, Health Service Executive Mid West","place":["Limerick, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"O'Rourke","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Limerick","place":["Limerick, Ireland"]},{"name":"Infectious Disease Department, Health Service Executive Mid West","place":["Limerick, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Murray","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Limerick","place":["Limerick, Ireland"]},{"name":"Rheumatology Department, Health Service Executive Mid West","place":["Limerick, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"B1","first-page":"70","article-title":"Diffuse fasciitis with eosinophilia: a new syndrome?","volume":"87","author":"Shulman","year":"1974","journal-title":"Trans Assoc Am Physicians"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.1056\/NEJMicm2212023","article-title":"Eosinophilic fasciitis","volume":"388","author":"Shaw","year":"2023","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.alit.2019.03.001","article-title":"Eosinophilic fasciitis: from pathophysiology to treatment","volume":"68","author":"Ihn","year":"2019","journal-title":"Allergol Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/0049-0172(88)90008-X","article-title":"Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases","volume":"17","author":"Lakhanpal","year":"1988","journal-title":"Semin Arthritis Rheum"},{"key":"B5","doi-asserted-by":"publisher","first-page":"778211","DOI":"10.3389\/fmed.2021.778211","article-title":"Interstitial lung disease is a major characteristic of patients who test positive for anti-PM\/Scl antibody","volume":"8","author":"Ge","year":"2022","journal-title":"Front Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s13075-015-0573-x","article-title":"Anti-PM\/Scl antibodies are found in Japanese patients with various systemic autoimmune conditions besides myositis and scleroderma","volume":"17","author":"Muro","year":"2015","journal-title":"Arthritis Res Ther"},{"key":"B7","article-title":"Scleroderma and related disorders","volume-title":"Textbook of Pediatric Rheumatology","author":"Li","year":"2021"},{"key":"B8","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1111\/1756-185X.14284","article-title":"Eosinophilic fasciitis induced by a game of drumming probably via type 2 innate immunity","volume":"25","author":"Watanabe","year":"2022","journal-title":"Int J Rheum Dis"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.1016\/j.jtho.2019.09.011","article-title":"Eosinophilic fasciitis triggered by nivolumab: a remarkable efficacy of the mTOR inhibitor sirolimus","volume":"15","author":"Le Tallec","year":"2020","journal-title":"J Thorac Oncol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1634\/theoncologist.2019-0508","article-title":"Eosinophilic fasciitis following checkpoint inhibitor therapy: four cases and a review of the literature","volume":"25","author":"Chan","year":"2020","journal-title":"Oncologist"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1016\/j.jaad.2021.05.030","article-title":"Drug-induced eosinophilic fasciitis: a dual pharmacovigilance analysis","volume":"86","author":"Teboul","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"41","DOI":"10.55563\/clinexprheumatol\/am8x3p","article-title":"Eosinophilic fasciitis induced by certolizumab pegol: association or coincidence?","author":"Wang","year":"2022","journal-title":"Clin Exp Rheumatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"376","DOI":"10.31138\/mjr.32.4.376","article-title":"Eosinophilic fasciitis following checkpoint inhibitor therapy with pembrolizumab","volume":"32","author":"Zampeli","year":"2021","journal-title":"Mediterr J Rheumatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1177\/120347540100500108","article-title":"Eosinophilic fasciitis occurring four weeks after the onset of dialysis in a renal failure patient","volume":"5","author":"Florell","year":"2001","journal-title":"J Cutan Med Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.jdcr.2021.09.010","article-title":"Eosinophilic fasciitis as a paraneoplastic syndrome in melanoma","volume":"17","author":"Rea","year":"2021","journal-title":"JAAD Case Rep"},{"key":"B16","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.amjmed.2021.08.022","article-title":"Eosinophilic fasciitis unmasking a lung cancer","volume":"135","author":"Vandamme","year":"2022","journal-title":"Am J Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s40674-016-0038-7","article-title":"Scleroderma mimickers","volume":"2","author":"Morgan","year":"2016","journal-title":"Curr Treat Options Rheumatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"71101","DOI":"10.47829\/ACMCR.2021.71101","article-title":"Chronic graft versus host disease: an update on the clinical characterization and diagnostic assessment of cutaneous and articular sclerotic forms","volume":"7","author":"Calleja","year":"2021","journal-title":"Ann Clin Med Case Rep."},{"key":"B19","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/j.berh.2012.08.001","article-title":"Eosinophilic fasciitis (Shulman disease)","volume":"26","author":"Lebeaux","year":"2012","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/s40257-017-0269-x","article-title":"Morphea and eosinophilic fasciitis: an update","volume":"18","author":"Mertens","year":"2017","journal-title":"Am J Clin Dermatol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1111\/cup.12947","article-title":"Th1- and Th17-polarized immune infiltrates in eosinophilic fasciitis: a potential marker for histopathologic distinction from morphea","volume":"44","author":"Moy","year":"2017","journal-title":"J Cutan Pathol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1097\/CM9.0000000000001078","article-title":"Clinical and pathologic features and therapeutic management of eosinophilic fasciitis","volume":"134","author":"Li","year":"2021","journal-title":"Chin Med J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1111\/1346-8138.15561","article-title":"Characteristics of Japanese patients with eosinophilic fasciitis: a brief multicenter study","volume":"47","author":"Yamamoto","year":"2020","journal-title":"J Dermatol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12969-024-00960-w","article-title":"Juvenile eosinophilic fasciitis: a single center case series","volume":"22","author":"Stubbs","year":"2024","journal-title":"Pediatr Rheumatol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.3390\/ijms24031982","article-title":"Eosinophilic fasciitis: current and remaining challenges","volume":"24","author":"Mazilu","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B26","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.clindermatol.2018.04.006","article-title":"Eosinophilic fasciitis: current concepts","volume":"36","author":"Fett","year":"2018","journal-title":"Clin Dermatol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s13075-025-03574-z","article-title":"Clinicopathological profile of eosinophilic fasciitis: a retrospective cohort study from a neuromuscular disorder center in China","volume":"27","author":"Wang","year":"2025","journal-title":"Arthritis Res Ther"},{"key":"B28","doi-asserted-by":"publisher","first-page":"3751","DOI":"10.1002\/art.27704","article-title":"Fasciitis as a common lesion of dermatomyositis, demonstrated early after disease onset by en bloc biopsy combined with magnetic resonance imaging","volume":"62","author":"Yoshida","year":"2010","journal-title":"Arthritis Rheum"},{"key":"B29","doi-asserted-by":"publisher","first-page":"33","DOI":"10.37897\/RJR.2021.1.6","article-title":"Two case reports and a literature review on eosinophilic fasciitis","volume":"30","author":"Mazilu","year":"2021","journal-title":"Rom J Rheumatol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1177\/12034754251338831","article-title":"Treatment outcomes of eosinophilic fasciitis: a systematic review","volume":"29","author":"Bestavros","year":"2025","journal-title":"J Cutan Med Surg."},{"key":"B31","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1016\/j.jaad.2022.08.026","article-title":"Cluster analysis reveals eosinophilia and fibrosis as poor prognostic markers in 128 patients with eosinophilic fasciitis","volume":"87","author":"Chaigne","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1001\/jamadermatol.2020.0120","article-title":"Mycophenolate mofetil for eosinophilic fasciitis: a retrospective analysis from 3 tertiary care centers","volume":"156","author":"Tkachenko","year":"2020","journal-title":"JAMA Dermatol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/S2213-2600(20)30318-0","article-title":"Tocilizumab in systemic sclerosis: a randomized, double-blind, placebo-controlled, phase 3 trial","volume":"8","author":"Khanna","year":"2020","journal-title":"Lancet Respir Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1007\/s00296-021-04887-3","article-title":"Rituximab for refractory eosinophilic fasciitis: a case series with long-term follow-up and literature review","volume":"41","author":"Kougkas","year":"2021","journal-title":"Rheumatol Int"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.1093\/rheumatology\/keq062","article-title":"Infliximab may be effective in the treatment of steroid-resistant eosinophilic fasciitis: report of three cases","volume":"49","author":"Khanna","year":"2010","journal-title":"Rheumatology"},{"key":"B36","doi-asserted-by":"publisher","first-page":"948","DOI":"10.3899\/jrheum.200998","article-title":"Successful treatment with baricitinib in a patient with refractory eosinophilic fasciitis","volume":"48","author":"Sehgal","year":"2021","journal-title":"J Rheumatol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.1016\/j.jaad.2019.12.022","article-title":"Intravenous immunoglobulin for refractory eosinophilic fasciitis: a retrospective analysis from 3 tertiary care centers","volume":"88","author":"Tkachenko","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1111\/ijd.16003","article-title":"UVA-1 phototherapy as adjuvant treatment for eosinophilic fasciitis: in vitro and in vivo functional characterization","volume":"61","author":"Tognetti","year":"2022","journal-title":"Int J Dermatol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.55563\/clinexprheumatol\/j7gexb","article-title":"Mepolizumab for refractory eosinophilic fasciitis: a retrospective analysis from two tertiary care centers","volume":"41","author":"Sanchez-Melendez","year":"2023","journal-title":"Clin Exp Rheumatol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1001\/jamadermatol.2015.3648","article-title":"Epidemiology and treatment of eosinophilic fasciitis: an analysis of 63 patients from 3 tertiary care centers","volume":"152","author":"Wright","year":"2016","journal-title":"JAMA Dermatol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1142\/S2424835520720054","article-title":"Eosinophilic fasciitis: beware of the rare form of hand contracture","volume":"25","author":"Ou Yang","year":"2020","journal-title":"J Hand Surg Asian Pac"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1870461\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:08:28Z","timestamp":1785164908000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1870461\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":41,"alternative-id":["10.3389\/fmed.2026.1870461"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1870461","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]},"article-number":"1870461"}}