Dermatomyositis

Dermatomyositis, a member of the collagen vascular disease group with myositis as the predominant clinical feature, is manifested in the skin by a pink-violaceous heliotrope hue of the periorbital skin, dilations of nail fold capillaries, erythema over small joints, erythematous 2 to 4 mm papules with some central scarring also over the joints, called Gottron's papules, as well as cutaneous eruptions resembling those seen in chronic subacute or acute lupus erythematosus.

Particularly in the elderly, dermatomyositis can be associated with internal cancer, often GI, as a paraneoplastic syndrome. In such cases, there is often an associated eosinophilia.

Treatment:

• For skin disease sunscreens are required;
• Topical steroids
• Hydroxychloroquine and chloroquine suppress skin activity

Resistant skin disease may require methotrexate, mycophenolate mofetil, Dapsone or IV immune globulin

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