Juvenile Dermatomyositis Presenting as Deep Skin Ulcerations as an Initial Manifestation / 대한피부과학회지

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.