UNUSUAL PATTERN OF LIMB EDEMA: THE SCHULMANS DISEASE. CONTRIBUTION OF IMAGERY

Schulmans disease is a uncommon pathology described by Shulman in 1974. It is an attack of the connective tissue characterized by a symmetrical, indurated, painful edema associating a thickening of the skin and soft tissues which usually sits on the limbs with possibility of migrating to the trunk. Eosinophilic fasciitis or Shulman syndrome presents two peaks of incidence, between 20 and 30 years of age and between 45 and 60 years of age. Some pediatric and geriatric cases are described in the literature. It occurs sporadically and there do not seem to be, with a few exceptions, family cases. The place of imaging is not well defined but seems to be useful for diagnosis (especially MRI). The diagnosis of certainty is brought by the biopsy of the fascia which finds a thickening of the fascias with infiltration of lymphocytes and macrophages with or without eosinophils..Essentially medical treatment with corticosteroids or immunosuppressants is enough in most cases. The prognosis of Schulman disease is generally good. The aim of this work is to present and recall the imaging characteristics of Schulman syndrome from an illustration of a case and reviewed from the literature.