Navigating complexity through “the groove”: eosinophilic fasciitis in the context of diabetes and lichen planus
- Affiliations
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- 1Department of Rheumatology & Clinical Immunology, All India Institute of Medical Sciences, Kalyani, India
Figure
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Figure 1 Clinical photographs. (A) Green arrows indicate flat topped skin lesions of lichen planus over anterior aspect of lower limbs. (B) Red arrows indicate characteristic linear depression along the course of veins of forearm, the “groove sign.” (C) Red arrows indicate characteristic linear depression along the course of veins at posterior aspect of bilateral knees, the “groove sign.” (D) Characteristic shiny, and “Peau d’orange” appearance of abdomen.
Figure 2 Magnetic resonance imaging (MRI) images. (A) Blue arrows indicate thickened fascia with contrast enhancement in MRI Ax T1 FS sequence of bilateral thighs. (B) Red arrow indicates hyper intense fascia on T2 sequence on forearm axial cut section.
Figure 3 Histopathology image (stain H&E, magnification x100). Epidermis shows keratinisation, flattening of rete ridges, and acanthosis; upper dermis shows inflammatory infiltrate comprising of lymphocytes, plasma cells, and eosinophils and fibrosis of sweat glands; and subcutis shows septal lymphocytic infiltrate with few eosinophils.
Reference
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1. Camard M, Maisonobe T, Flamarion E. 2022; The groove sign in eosinophilic fasciitis. Clin Rheumatol. 41:3919–20. DOI: 10.1007/s10067-022-06311-y. PMID: 35907103.2. Moghadam P, Bellaiche S, Mausoleo A, Cassius C, Zuelgaray E, Mahevas T, et al. 2023; Lichen planus associated with eosinophilic fasciitis outside the setting of chronic graft-versus-host disease. Ann Dermatol Venereol. 150:71–2. DOI: 10.1016/j.annder.2022.09.006. PMID: 36428118.
