Scalp involvement in dermatomyositis. Often overlooked or misdiagnosed.
OBJECTIVE
To characterize scalp involvement in patients with dermatomyositis.


METHODS
Case series.


METHODS
All patients with dermatomyositis seen in our office between 1988 and mid 1993. Patient inclusion in this study required fulfillment of three or more of Bohan and Peter's criteria for dermatomyositis.


RESULTS
Of 17 patients with the diagnosis of dermatomyositis, scalp involvement was present in 14. Five of the 14 patients with scalp involvement were diagnosed as having scalp psoriasis or seborrheic dermatitis before progression of their disease or tissue examination revealed the diagnosis of dermatomyositis. In all patients, the scalp involvement was manifested as atrophic, erythematous, scaly plaques. In addition, alopecia was noted in six of the 14 patients. Treatment of cutaneous involvement included sun avoidance, topical corticosteroids and/or antimalarials, and/or methotrexate.


CONCLUSIONS
Recognition of this process is important because scalp involvement is often overlooked, may be misdiagnosed initially, and can be the presenting complaint in some patients with dermatomyositis.
Kasteler
J S
JS
Division of Dermatology, University of Louisville, School of Medicine, KY.
Callen
J P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003882:Dermatomyositis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012536:Scalp Dermatoses / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy