Dermatomyositis is an idiopathic inflammatory process manifested by proximal muscle weakness and cutaneous lesions such as Gottron’s sign, heliotrope rash, erythematous photosensitive rash, or periungual erythema. Other unusual cutaneous manifestations are icthyosis, panniculitis, erythroderma, lichen planus, vesicle and bullae formation, follicular hyperkeratosis, malacoplakia, and papular mucinosis.¹ Administration of systemic agents such as corticosteroids, methotrexate (MTX), hydroxychloroquine (HCQ), mycophenolate mofetil, intravenous immunoglobulins, and/or azathioprine for the underlying systemic disease leads in many cases to remission of the cutaneous lesions. Nevertheless, many patients have resistant cutaneous lesions despite treatment. On the other hand, cutaneous lesions may be the major manifestation of the disease, making it difficult to justify systemic agents because of their side effects.

CASE REPORT

A 61 year old woman with dermatomyositis and cutaneous lesions, refractory to previous treatment, …