title: Unusual sequelae of adult-onset dermatomyositis.
abstract: A 44-year-old woman diagnosed with dermatomyositis 5 years ago based on progressive proximal muscle weakness, elevated creatine kinase, typical findings on electromyography and muscle biopsy. Despite the treatment, in contrast to improvement in her muscle symptoms, the heliotrope rash of her eyelids persisted. After several years, the patient developed multiple limited skin retraction lesions with hyperpigmentation on both lower limbs. Palpation of these lesions revealed dry, cold and very firm skin on both thighs and calves, particularly in the distal areas. X-ray and ultrasound imaging of the calves showed multiple subcutaneous calcifications in the distal muscles.
authors.affiliation: Department of Internal Medicine H, Rambam Health Care Campus, Haifa, Israel B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel Rappaport's Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Mohammad Ebrahim
authors.initials: ME
authors.lastname: Naffaa
authors.affiliation: B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Rema
authors.initials: R
authors.lastname: Bishara
authors.affiliation: B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel Rappaport's Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Braun-Moscovici
authors.affiliation: B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel Rappaport's Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Balbir-Gurman
mesh_terms: D000328:Adult; D001706:Biopsy; D003882:Dermatomyositis / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use*; D012867:Skin / Q000473:pathology*
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
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