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Lauren Flowers, BS

Pronouns

She/Her/Hers

Rank

Medical Student

Institution

University of Missouri School of Medicine

BWH-MGH Title

Medical Student Researcher

Department

Dermatology

Authors

Lauren Flowers*, Neda Shahriari, Nathaniel Goldman, Bina Kassamali, Daniel Mazori, Alisa Femia, Sarah Lonowski, Avery LaChance, Ruth Ann Vleugels

Diagnosing Fascial Involvement in a Cohort of Eosinophilic Fasciitis Patients

As a future first-generation physician, I feel empowered by the potential opportunity to present my team’s research at this year’s Women in Medicine and Science Symposium. My home medical institution is in Missouri, so I am especially grateful for the chance to meet and learn from so many other inspiring female scientists and leaders in the medical field. My current clinical and research interests include rheumatologic disorders with an emphasis on the dermatologic manifestations of those diseases. I also have a special interest in studying pediatric and underserved populations.

Background

Diagnosis of eosinophilic fasciitis (EF), a rare sclerosing disorder with fascial inflammation, is traditionally predicated on a full-thickness wedge biopsy. This can be difficult to obtain and presents wound healing challenges in sclerotic skin. Magnetic resonance imaging (MRI) is an alternative for evaluating fascial involvement in EF that has not previously been compared to a wedge biopsy.

Methods

A retrospective review of 54 patients with a diagnosis of EF was conducted to evaluate detection of fascial involvement by MRI and/or wedge biopsy. Thirty-nine patients met inclusion criteria for this study.

Results

Of the 39 patients included, 61.5% (n=24) had a wedge biopsy, 67% had an MRI, and 38.5% (n=15) had both a wedge biopsy and an MRI. Of those 15 patients, 12 patients (80%) had evidence of fascial involvement detected by both modalities. Overall, MRI had a sensitivity of 92.3% while wedge biopsy had a sensitivity of 91.7% in detecting fascial changes suggestive of EF.

Conclusion

Our data proposes that MRI may be noninferior to wedge biopsy for diagnosis of EF. Furthermore, MRI may be more favorable clinically given its less invasive nature and the potential to monitor treatment response over time.