This 52-year-old man developed acute onset of upper extremity edema and erythema in July, 2002. He subsequently developed paresthesias in his hands. A prednisone taper was initiated, but when the erythema and edema persisted and blisters appeared, he was diagnosed with cellulitis. Cultures grew methicillin resistant Staphylococcus aureus, and a prolonged course of intravenous antibiotics was administered. The edema progressed to induration and he developed contractures of the wrists. A right wrist carpal tunnel releae was performed as well as a deep fascial biopsy that revealed changes typical of eosinophilic fasciitis.
firm woody induration of the skin and subcutaneous tissue with overlying hyperpigmentation and minimal scale