Clinical Background:
Over a 3 month period, this 60 year old woman noticed the appearance of
erythematous plaques on the hands, elbows and periorbital areas with weakness,
diffuse arthralgia, fatigue, and weight loss.
She was therefore referred to our Department for further investigations:
physical examination revealed characteristic heliotrope (violaceous)
periorbital erythema and erythematous plaques (Gottron papules) overlying
the knuckles (on pre-existing white areas of vitiligo) and the elbows.
The CK (creatine kinase) and other muscle enzymes were always within the
normal range during follow-up despite muscle weakness, pain and focal evidence
of myopathy on EMG.
Interstitial pulmonary fibrosis was found on chest X-rays, CT scan and
respiratory function tests.
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