Dermatomyositis with Follicular Hyperkeratosis

Abstract

We report 2 cases of dermatomyositis with follicular hyperkeratosis (FHK) in children. They occurred in a 10-year-old Vietnamese girl and a 9-year-old Caucasian boy. The girl’s FHK disappeared after 2 months of treatment. The boy presented, 15 months after the onset of his dermatomyositis, with a generalised FHK which lasted for 6 months. FHK can appear before, during or after dermatomyositis. It is more often generalised but can be localised. Erector pili myositis and ostial hyperkeratosis may be the explanation. The prognostic value of FHK in dermatomyositis is unknown. This manifestation, initially considered to be more frequent in the Far East, is not as rare in Western countries as the few reported cases suggest.

Wong’s dermatomyositis: a new case and review of the literature

“…However, Requena et al 5 described hyperkeratosis also involving the interfollicular epidermis. 7,8 Dupré et al 7 postulated that the hair follicle involvement with erector pili myositis might alter the hair cycle, result-ing in anomalies of the infundibular keratinization and subsequent follicular keratotic plugging. In rare instances, erector pili myositis has been reported.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] Usually, these patients exhibit classical cutaneous lesions of dermatomyositis and stereotypical lesions of pityriasis rubra pilaris. [1][2][3][4][5][6][7][8][9][10][11][12] Usually, these patients exhibit classical cutaneous lesions of dermatomyositis and stereotypical lesions of pityriasis rubra pilaris.…”

Dermatomyositis with a Pityriasis Rubra Pilaris‐like Eruption: An Uncommon Cutaneous Manifestation in Dermatomyositis

“…Hyperkeratotic skin eruptions are a rare manifestation of DM and only a few instances have been reported in the literature (12)(13)(14)(15)(16)(17)(18) (18). In Table 1, we summarize a literature review of patients with DM and cutaneous eruptions resembling PRP.…”

Papules and Pustules of the Elbows and Knees: An Uncommon Clinical Sign of Dermatomyositis in Oriental Children

“…This raises the possibility that Oriental patients are predisposed to such lesions. It is interesting that both of our patients and one described by de la Tribonniere et al (5) were Oriental.…”

“…These were biopsied in our second patient and the specimen showed a hyperkeratotic plugged follicle with a surrounding inflammatory cell infiltrate. De la Tribonniere et al (5) reported histologic changes suggesting arrector pili myositis. They suggested that this might be the mechanism by which follicular lesions arise in dermatomyositis.…”