Unusual sequelae of adult-onset dermatomyositis

Abstract

A 44-year-old woman diagnosed with dermatomyositis 5 years ago based on progressive proximal muscle weakness, elevated creatine kinase, typical findings on electromyography and muscle biopsy. Despite the treatment, in contrast to improvement in her muscle symptoms, the heliotrope rash of her eyelids persisted. After several years, the patient developed multiple limited skin retraction lesions with hyperpigmentation on both lower limbs. Palpation of these lesions revealed dry, cold and very firm skin on both thighs and calves, particularly in the distal areas. X-ray and ultrasound imaging of the calves showed multiple subcutaneous calcifications in the distal muscles.

Clinical Evaluation and Management of Inflammatory Myopathies

“…1 and 2, ►Table 2). 18,19 The rash can precede, accompany, or develop years after the muscle weakness. 20 There is also a form of amyopathic dermatomyositis, also known as dermatomyositis sine myositis, in which patients can have a characteristic rash without muscle weakness; this can occur in up to 20% of cases.…”