Fasciitis, one of the presentations of chronic skin
graft-versus-host disease (GVHD), is characterized by symmetrical inflammatory swelling of extremities with or without
eosinophilia, but it is rarely reported. This article describes a patient with the clinical and histologic features of
fasciitis, as the only form of chronic GVHD that developed 20 months after HLA-matched allogeneic peripheral
hematopoietic stem cell transplantation (HSCT) for
chronic myelogenous leukemia (CML). She reported tightness of the skin and
pain in both wrists and elbows on motion, with
edema of the limbs. A deep cutaneous biopsy showed thickening of the subcutaneous fascia with inflammatory infiltrates. The patient was treated with
cyclosporine and
prednisone, which resulted in much improvement of her symptoms and signs related to the
fasciitis. The authors recommend that clinicians maintain a high index of suspicion for
fasciitis because
fasciitis is a distinct entity among the chronic GVHD that may lead to a functional disability.