title: Dermatomyositis associated with hepatitis B virus-related hepatocellular carcinoma.
abstract: Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) with typical cutaneous manifestations. It has been proposed that DM may be caused by autoimmune responses to viral infections, and previous studies have also shown that an association between DM and malignancy. However, chronic hepatitis B virus (HBV) infection associated with DM and hepatocellular carcinoma (HCC) is rarely encountered. The authors report a case of DM and HCC in a patient with a HBV infection. A 58-year-old man presented erythematous skin rashes on a sun-exposed area of 2 year's duration, and recent proximal muscle weakness. His medical history revealed that he had a chronic HBV infection. A diagnosis of DM relies on proximal muscle weakness, elevated muscle enzymes, myopathic changes (demonstrated by electromyography), muscle biopsy evidence of myositis, and its characteristic cutaneous findings. A Liver mass in the left lobe visualized by abdominal computed tomography was confirmed histologically as HCC. This case suggests that DM associated with HCC might be caused by a HBV infection.
authors.affiliation: Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Kee
authors.forename: Tae-Jong
authors.initials: TJ
authors.lastname: Kim
authors.forename: Sung-Ji
authors.initials: SJ
authors.lastname: Lee
authors.forename: Young-Nan
authors.initials: YN
authors.lastname: Cho
authors.forename: Seong-Chang
authors.initials: SC
authors.lastname: Park
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Jeong-Chul
authors.initials: JC
authors.lastname: Kim
authors.forename: Hyung-Sik
authors.initials: HS
authors.lastname: Kang
authors.forename: Shin-Seok
authors.initials: SS
authors.lastname: Lee
authors.forename: Yong-Wook
authors.initials: YW
authors.lastname: Park
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D003882:Dermatomyositis / Q000175:diagnosis* / Q000821:virology*; D017809:Fatal Outcome; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography