A rare case of suspected lupus erythematosus panniculitis as the presenting skin feature of juvenile dermatomyositis: A case report

Abstract

Juvenile dermatomyositis is a rare autoimmune myopathy of childhood, associated with systemic vasculopathy, primarily affecting the capillaries. Panniculitis is seen histologically in about 10% of patients with dermatomyositis; however, its clinical presentation is rare, with only 30 cases presented in the literature to date. The histopathology overlaps with other inflammatory disease states, and is almost identical to the panniculitis seen in lupus erythematous panniculitis. In the cases with both panniculitis and dermatomyositis, skin and muscle inflammation is usually the first clinical manifestation. We present a case of a 16-year-old female with panniculitis as the initial presenting feature of juvenile dermatomyositis in the context of a prior diagnosis of indeterminate colitis.

A 9‐year‐old child with painful nodules on the leg

“…[3][4][5] LP may also be present in association with other connective tissue disorders, such as scleroderma or polymyositis. [6][7][8] The differential diagnosis for LP includes erythema nodosum, pancreatic panniculitis, morphea profunda, cold panniculitis, panniculitis associated with interferonopathies, 9 and subcutaneous panniculitis-like T-cell lymphoma (SPTCL), which may be clinically identical to LP. 10 Laboratory testing, including ANA, ENA, inflammatory markers, complement, and CBC, can be normal as in our case, so histopathology is crucial to confirm a diagnosis of LP.…”

“…In children with LP, the risk of progression to SLE is unknown 3–5 . LP may also be present in association with other connective tissue disorders, such as scleroderma or polymyositis 6–8 …”