July 1, 2003
Clarence William Brown, Jr, MD

Stephanie F. Marschall, MD

This inflammatory myopathy is believedto be related to immune-mediatedmuscle damage. An increased incidenceof malignancy is associatedwith dermatomyositis (DM), especiallyin patients older than 50 years.

This inflammatory myopathy is believed to be related to immune-mediated muscle damage.1 An increased incidenceof malignancy is associated with dermatomyositis (DM), especiallyin patients older than 50 years.2The characteristic cutaneous features of DM are heliotrope rash and Gottron papules. The rash is a dark,violaceous, erythematous discoloration usually distributed symmetrically over the periorbital skin (A). It mayor may not be associated with edema. Gottron papules are firm, erythematous papules found over bony prominences,especially the metacarpophalangeal,proximal, and distal interphalangealjoints (B). They can precedeclinically obvious muscle disease.Less characteristic skin lesionsof DM include malar erythema, poikilodermain a photosensitive distribution,violaceous erythema on theextensor surfaces, and periungualand cuticular changes. Patients mayalso exhibit periungual telangiectasiawith hypertrophic changes of the cuticleand small infarcts.