Dermatomyositis

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51 year-old-man, without history of disease, who had smoked 40-pack years, presented ten months before his admission, with an erythematous and scaly eruption over the extensor surfaces of the metacarpophalangeal joints and digits, knees were also affected ( illustration 1). The diagnosis of dermatomyositis was established after pathologic examination of muscular biopsy. Chest X-rays showed a left apical opacity. Chest and abdominal CT showed an apical lung tumor and right adrenal lesion suggestive of metastasis ( Illustration 2). CT-guided biopsy of the lung lesion revealed a squamous cell carcinoma. A systemic treatment was initiated, unfortunately the patient died following a septic shock, which occurred after 2 courses of chemotherapy. Dermatomyositis may be associated with malignancies type lymphoma or melanoma in 15% of adults over 40 years, however, the association with solid tumors is rare (1-2). The histology is variable: adenocarcinoma, squamous cell carcinoma, small cell carcinoma and others (2). Cancer treatment usually leads to a regression of symptoms of dermatomyotisis but the reappearance of clinical symptoms should call for a recurrence or distant metastasis (1)

References

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1. Irwin M, Braverman MD. Skin manifestations of internal malignancy. Clinics in Geriatric Medicine2002; 18(1), 1-19  2. Yang Y, Fujita J, Tokuda M, Bandoh S, Ishida T. Lung cancer associated with several connective tissue diseases: with a review of literature. Rheumatol Int 2001;21(3):106 -11

Source(s) of Funding

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Research finding based on pubmed 

Competing Interests

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Authors declares no competing interests

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