Diagnosis: Dermatomyositis (periungual erythems and telangiectasia)
Case submitted by Alaa Saad to the dermRounds community.
Clinical photograph(s) submitted for peer review and discussion.
Submitted by Alaa Saad. Originally posted October 8, 2010.
See case discussion.
• Systemic lupus erythematosus • Polymyositis • Contact dermatitis • Seborrheic dermatitis • Psoriasis • Drug eruption • Photosensitive eruption • Trichinosis
• Classic cutaneous findings: heliotrope rash (violaceous periorbital erythema), Gottron papules (over MCPs/IPs/knees/elbows), V-sign, shawl sign • Gottron papules are pathognomonic for dermatomyositis • Adult dermatomyositis has significant malignancy association (~15-30%) — cancer screening essential • Myositis-specific antibodies: anti-Mi-2, anti-MDA5 (amyopathic DM with ILD risk), anti-TIF1-gamma (cancer association) • Amyopathic DM: skin disease without muscle involvement for ≥6 months • Anti-MDA5 DM associated with rapidly progressive interstitial lung disease • Nailfold capillaroscopy shows dilated, tortuous capillary loops with dropout
Tags: dermatomyositis, periungual, erythems, and, telangiectasia, alaa saad