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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Eosinophilic fasciitis is an uncommon scleroderma-like disease of unknown etiology&#46; It was first described by Shulman in 1974&#44; and is characterized clinically by a subcutaneous induration and its development predominantly in the limbs&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> Eosinophilia is detected in peripheral blood in 80&#37; of the patients&#44; and more than 50&#37; present with hypergammaglobulinemia&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case Report</span><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 45-year-old man&#44; with nothing remarkable in his medical record&#44; who presented with a 6-month history of thickening and induration of upper and lower limbs&#44; which had an important functional impact on his activities of daily living&#46; The patient participated in sports&#44; but recalled no noteworthy injuries or other possible triggering factor&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Aside from the above-mentioned induration&#44; the physical examination revealed furrows along the length of the veins of the superficial plexus&#44; a phenomenon classically referred to as the &#8220;groove sign&#8221;&#46; On the other hand&#44; the skin on extensor surfaces was shiny&#44; erythematous and edematous&#44; with marked follicular orifices&#44; which gave it the appearance of an &#8220;orange peel&#8221; or &#8220;peau d&#8217;orange&#8221; &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46; Full-thickness skin biopsy disclosed thickening of the muscle fascia&#44; together with a mixed inflammatory infiltrate composed of lymphocytes&#44; plasma cells and scattered eosinophils &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Laboratory tests revealed blood eosinophilia with a count of 1000<span class="elsevierStyleHsp" style=""></span>cells&#47;mm<span class="elsevierStyleSup">3</span>&#46; With a diagnosis of eosinophilic fasciitis&#44; treatment was begun with prednisone at a dose of 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day and&#44; later&#44; with methotrexate&#46; The signs and symptoms improved progressively over the following months&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">The diagnosis of eosinophilic fasciitis is based mainly on a histological study&#44; requiring a full-thickness skin biopsy that includes muscle fascia&#46; However&#44; knowledge of the forms of clinical presentation is necessary to establish diagnostic suspicion&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> The groove sign is a highly specific finding&#44; and is often accompanied by &#8220;peau d&#8217;orange&#8221;&#46; It consists of furrowing along the length of the veins of the superficial plexus&#44; which becomes more marked when the limb is raised&#46; It is thought to be due to the fact that&#44; as the epidermis and superficial dermis are not affected&#44; they maintain their elasticity and&#44; thus&#44; they are depressed upon the collapse of the superficial veins&#44; which are surrounded by inflamed&#44; fibrotic tissue&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Ethical Disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest&#46;</p></span></span>"
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