A retrospective diagnosis of eosinophilic fasciitis was made in a patient with disabling contractural disease of 20 years' duration. Chronic moderate-dose corticosteroid therapy had failed to halt either clinical or histological progression of the disease, but rapid worsening of skin thickening and contracture followed withdrawal of prednisone. Muscle wasting was severe in spite of normal serum creatine kinase levels; urinary excretion of creatinine was consistently elevated.
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