A Case of Dermatomyositis: Diagnostic Challenge in Low Resource Settings

Dermatomyositis is one of the idiopathic inflammatory myopathies. It is characterized clinically by progressive symmetrical proximal muscle weakness and a characteristic rash. Although the process primarily attacks the skin and the muscles, it is a systemic disease with frequent manifestations in the gastrointestinal tract and pulmonary system. Dermatomyositis has been linked to internal malignancy in somewhere between 15% and 25%. We report a case involving a 30 years old female nurse who presented with extensive erythema involving face and upper neck, and deteriorating proximal muscular weakness for three months. Later muscle enzymes, EMG and biopsy were done from BSMMU, Dhaka, confirmed the diagnosis of Dermatomyositis. Oral prednisolone along with azathioprine, hydroxychloroquine and photo protection with sun screen were started and showed good response both clinically and biochemically.