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We present a clinical case of a 75-year-old woman hospitalized for localized edema and erythema on the right hemiface, with progressive extension over 30 days. On objective examination, a heliotropic erythema, Gottron's papules and an ulcerated lesion on the right breast were founded. It's important to point out an increase of muscle enzymes in laboratory tests. According to classification criteria of the European League against Rheumatism, and taking into consideration the clinical suspicion of breast cancer, a paraneoplastic dermatomyositis was diagnosed. Highlight that dermatomyositis lesions are pathognomonic despite that they are not always recognized in the patient's first approach.