Diagnosis: Dermatomyositis
Description: Heliotrope rash.
Morphology: Swelling
Site: Face
Sex: M
Age: 61
Type: Clinical
Submitted By: Nameer Al-Sudany
Differential DiagnosisHistory: An old man presented with a characteristic periorbital purplish discoloration (Heliotrope rash). It was associated with malar erythema and edema, less striking erythema of the neck and presternal area (shawl sign)and atrophic papules over the knuckles of the fingers (Gottron’s papules). The skin signs have appeared simultaneously with muscle symptoms (weakness of proximal muscles). No underlying tumour was found. Investigations revealed: normal ESR, negative ANA, Elevated CPK and abnormal EMG.