Generalized morphea/eosinophilic fasciitis overlap after epoxy exposure

• Main Authors: Warren H. Chan, MS, Daniel J. Lewis, BA, Esther J. Kim, BA, Phyu P. Aung, MD, Madeleine Duvic, MD
• Format: Article
• Language: English
• Published: Elsevier 2018-03-01
• Series: JAAD Case Reports
• Subjects: azathioprine; eosinophilic fasciitis; epoxy; generalized morphea; phototherapy; ultraviolet A1
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352512617302126

Generalized morphea is associated with epoxy resin vapors and is characterized by the development of lesions shortly after exposure. Morphea presenting along with eosinophilic fasciitis (EF), or morphea/EF overlap, is rare and an indicator of poor prognosis and resistance to treatment. Here we present a case of generalized morphea/EF overlap linked to epoxy exposure. Our patient received multiple therapies—ultraviolet A1 phototherapy, prednisone, methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, cyclosporine, and rituximab—none of which led to a significant response. The refractory nature of this disease warrants vigilance in its association with epoxy exposure.