Dermatomyositis Case Study

Abstract
Dermatomyositis (DM) is an autoimmune disease that presents with a wide range of classical dermatologic findings and proximal muscle weakness. Like other autoimmune diseases, multiple trigger mechanisms have been proposed in the pathogenesis of DM. They include infections, drugs, environmental factors and malignancy. Majority of the cases are idiopathic, but in approximately 15–30% of cases of adult-onset DM, an underlying malignancy is the cause of a paraneoplastic syndrome manifested as DM. We present a case of a 31 years old female who presented to us with a heliotrope rash, gottron papules, and shawl signs associated with proximal muscle weakness. She had no history of any constitutional symptoms of malignancy, however incidentally she was found to having a small palpable lymph node in her axilla. Later on screening she was diagnosed as having breast cancer. This case is a reminder that a common disease (breast cancer) may present with uncommon features (DM as a paraneoplastic syndrome), and physicians must consider malignancy as the underlying systemic process when an adult patient presents with DM.
Key Words Dermatomyositis, paraneoplastic syndrome, Breast cancer
Introduction

Case Report

She complained of gradual development of painful swelling and erythematous skin rashes over her face, neck, hands, chest and upper back. She also complained of gradual difficulty rising from sitting, climbing stairs and combing her hair. Symptoms progressively increased over time and she was unable to carry out her daily chores. She described symptoms of progressive dysphagia for solids. There was no history of weight loss, fever, and shortness of breath, oral ulcers, arthralgia, and