Amyopathic dermatomyositis presenting as panniculitis "hidden in the mist"

Publication Date

2013

Document Type

Research

Abstract

The inflammatory myopathies, commonly described as idiopathic, are the largest group of acquired and potentially treatable myopathies. Dermatomyositis is one of this kind. Presenting the 1st local case of Amyopathic Dermatomyositis presenting as Panniculitis. This is a case of a 26 year old, Filipino, male, sought to a private clinic with complaints of palpitations, abdominal pain and easy fatigability. History revealed tender erythematous nodules on the hip area and later on the abdomen, chest, upper and lower extremities of 3 months duration associated with easy fatigability, palpitations and abdominal pain. Initially diagnosed to have subacute hyperthyroidism and was treated with methimazole (MMI) 5mg /table, 1 tab BID. However, nodules persisted later associated with periorbital edema and heliotrope rash. Biopsy of the nodules revealed lobular panniculitis with vasculitis consistent with connective tissue disease. The exact pathogenesis of panniculitis in dermatomyositis in unclear? All the connective tissue diseases have inflammatory phases that may involve the panniculus. However, panniculitis in dermatoyositis is rare clinically. Dermatomyositis affects both children and adults, women more than men. The frequency dermatomyositis effects both children and adults, women more than men. The frequency dermatomyositis range from 0.6 to 1.0 per 100 000. The objective of this study is to present the first case of a Filipino patient with Amyopathic dermatomyositis with panniculitis; briefly describe the cutaneous manifestations of the disease and review the management that can be offered to the patient.

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