In Reply.—We read with interest the letter submitted by Yarom and Levinson in response to our case report "Eosinophilic Fasciitis in the Child."1 After reviewing the clinical and laboratory characteristics of their patient, we would agree with the diagnosis of morphea and linear scleroderma. We wonder, however, whether or not the focal eosinophilia with chronic fasciitis was a secondary inflammatory response to the primary disease process of linear scleroderma, rather than eosinophilic fasciitis as described in our case. Their biopsy specimen was most consistent with localized scleroderma since they documented dermal perivasculitis and collagenosis, characteristics of a biopsy specimen not found in eosinophilic fasciitis.
Although we consider eosinophilic fasciitis to be a distinct entity from linear scleroderma, morphea, systemic sclerosis, and other collagen vascular diseases, we note that there is some overlap in clinical and laboratory findings. Eosinophilia has been described not only in eosinophilic fasciitis, but also in morphea