Korean J Dermatol.  2014 Mar;52(3):169-172.

Juvenile Dermatomyositis Presenting as Deep Skin Ulcerations as an Initial Manifestation

• Kwon SY
• Chae JK
• Park SH
• Ko JY
• Park SD
• Park K

Abstract

Juvenile dermatomyositis is a common idiopathic inflammatory myopathy in childhood and is characterized by symmetric proximal muscle weakness and specific cutaneous manifestations. We here report on a 12-year-old boy who presented with violaceous maculopatches with multiple deep skin ulcerations on the right arm and lower back 4 months ago. One month after the initial visit, he had difficulty climbing stairs and elevating his arms above the head. Laboratory tests showed elevation of the serum levels of skeletal muscle enzymes, and electromyogram and muscle biopsy indicated myopathy. Histopathological analysis of the ulceration indicated necrotizing vasculitis and calcification. Based on these findings, his condition was diagnosed as juvenile dermatomyositis. We believe that this case is unique because of the difficulty in diagnosing the condition, as skin ulceration is a rare cutaneous manifestation of dermatomyositis.

Keyword

Juvenile dermatomyositis; Skin ulceration

MeSH Terms

Arm
Biopsy
Child
Dermatomyositis*
Head
Humans
Male
Muscle Weakness
Muscle, Skeletal
Muscular Diseases
Myositis
Skin Ulcer*
Ulcer
Vasculitis