Development of Eosinophilic Fasciitis during Infliximab Therapy for Psoriatic Arthritis

Figure 1

Deltoid muscle biopsy. (a) Low power view showing marked thickening and edema of epimysium and, to lesser extent, perimysium accompanied by diffuse chronic inflammation (H&E stain). There is only minor focal involvement of underlying endomysium. Muscle fascicles are relatively spared. (b) Higher power view of epimysium demonstrating noncohesive chronic inflammation and rarefaction/necrosis of connective tissue (H&E stain). A single necrotic fiber undergoing phagocytosis is observed in the adjacent fascicle. (c) Infiltrates are composed primarily of histiocytes, highlighted as red-staining cells in this preparation (acid phosphatase stain). (d) High power view of more focal collection of eosinophils within the epimysium (H&E stain).

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