Due to limited understanding of its pathogenesis, resistance to conventional immunosuppressive agents, and detrimental effects on physical function and quality of life, chronic graft-versus-host disease (cGVHD) emulating eosinophilic fasciitis (EF) is a challenging complication that is often misdiagnosed. The purpose of this study was to offer a thorough literature review on EF involvement due to cGVHD and to explain the clinical-biological aspects and responsiveness to the treatment of a case series. Research protocol for a prospective observational study describing the clinical and diagnostic evaluation characteristics of patients receiving EF-like follow-up as part of their multidisciplinary cGVHD consultations. Musculoskeletal manifestations of chronic graft-versus-host disease were also thoroughly evaluated, including those that affect the joints and/or fascia. The incidence of fasciitis among the 118 patients assessed in cGVHD consultations was 33%. About 11  patients had sclerotic skin but only joint contractures. Most patients showed improvement after receiving a median of 3 therapy regimens. There were 94 publications that could have qualified based on the search approach, but only 17 were chosen. Most of these were case reports that were conducted in isolation. The evaluation made use of the Joint and Fascial Score and the Photographic Range of Motion, both of which were established staging measures. It is important to identify and assess the extent of any fascial/articular involvement right away. There is a dearth of research on the complications of cGVHD affecting the fascia and joints. The prognosis of patients with cGVHD may be enhanced by the use of modern imaging techniques, the identification of novel biomarkers, and the application of a multidisciplinary approach.

Source: advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-022-00262-3