title: Dermatomyositis presenting with focal scleroderma-like skin changes.
abstract: OBJECTIVE
  To describe an unusual focal scleroderma-like skin changes in patient with dermatomyositis.
  
  
  METHODS
  Review of clinical records, laboratory investigations, and muscle and skin biopsies.
  
  
  RESULTS
  The patient developed unusual skin lesions characterized by symmetrical atrophy and hardening of focal skin and muscle over the lateral upper arms and posterior shoulders, and the left temporal and pectoral areas. Extensive blood work-up for scleroderma and other connective-tissue diseases was negative. A skin biopsy showed distinct pathologic features including increased interstitial mucin, hyperpigmentation, and perivascular lymphocytic inflammation without severe fibrosis. The scleroderma-like skin changes and muscle weakness improved with immunotherapy.
  
  
  CONCLUSIONS
  Dermatomyositis can manifest with focal scleroderma-like skin changes clinically and reticular erythematous mucinosis-like changes pathologically, and these distinct skin changes represent a new variant of skin lesions of dermatomyositis.
authors.affiliation: Wesley Neurology Clinic, Memphis, TN 38104, USA. ychai2@uthsc.edu
authors.forename: Yaohui
authors.initials: Y
authors.lastname: Chai
authors.forename: Tulio E
authors.initials: TE
authors.lastname: Bertorini
authors.forename: Raja B
authors.initials: RB
authors.lastname: Khan
authors.forename: M Barry
authors.initials: MB
authors.lastname: Randall
authors.forename: Mariallan K
authors.initials: MK
authors.lastname: Shadle
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology; D001706:Biopsy; D003882:Dermatomyositis / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D018908:Muscle Weakness / Q000209:etiology; D012594:Scleroderma, Localized / Q000150:complications* / Q000473:pathology*; D012867:Skin / Q000473:pathology*