title: Periorbital edema as the presenting sign of dermatomyositis.
abstract: BACKGROUND
  Periorbital edema can occur in dermatomyositis, which is characterized by symmetric macular erythema, Gottron's papules, Gottron's sign, periungual telangiectasia, heliotrope rash, and poikilodermatous macules on the shoulders, arms, or upper back (shawl sign).
  
  
  METHODS
  We report the case of an 81-year-old man with dramatic periorbital edema. It was not until he was hospitalized with dysphagia 6 months after developing the edema that the diagnosis of dermatomyositis was considered.
  
  
  RESULTS
  Laboratory tests, skin biopsy, and electromyography resulted in a diagnosis of dermatomyositis.
  
  
  CONCLUSIONS
  Periorbital edema may appear as the presenting cutaneous manifestation of dermatomyositis.
authors.affiliation: Department of Dermatology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: V C
authors.initials: VC
authors.lastname: Hall
authors.forename: J H
authors.initials: JH
authors.lastname: Keeling
authors.forename: M D P
authors.initials: MD
authors.lastname: Davis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D003882:Dermatomyositis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004487:Edema / Q000188:drug therapy / Q000209:etiology*; D005141:Eyelid Diseases / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone