Treatment With High Dose Methotrexate in Patients With Eosinophilic Fasciitis

Inclusion Criteria: * Eosinophilic fasciitis as defined by clinical judgement of an expert, * Histologically confirmed with a skin-fascia-muscle biopsy, and in additon: * Either the presence of a modified skin score according to Zachariae of 8 or higher (0-18), regarded as a generalised eosinophilic fasciitis or the presence of severe contractures due to eosinophilic fasciitis lesions. Exclusion Criteria: * Age \< 18 yrs * Contraindications to MTX: AST/ALT level \> 2 times upper limit of normal, WBC count \< 3.5 x 109/l or platelet count \< 150 x 109/l, serum creatinine \> 130 micromol/l or clearance \< 50 ml/min, confirmed by two repeated tests within one month. * Chronic liver disease, insulin dependant diabetes mellitus, alcohol abuse * Restrictive pulmonary disease (total lung capacity or vital capacity \< 40% of predicted) or interstitial lung disease (KCO \< 60% of predicted) * Pregnancy or child bearing potential without adequate contraception * The presence of any serious co-morbidity or malignancy * Use of other anti-folate drugs than MTX