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Rare disease
Case report
A rare form of dermatomyositis associated with muscle weakness and normal creatine kinase level
  1. Christopher Kwan1,
  2. Suzana Milosevic1,
  3. Helen Benham2 and
  4. Ian A Scott1
  1. 1Department of General Medicine, Princess Alexandra Hospital Health Service District, Brisbane, Queensland, Australia
  2. 2Department of Rheumatology, Princess Alexandra Hospital Health Service District, Brisbane, Queensland, Australia
  1. Correspondence to Dr Christopher Kwan; chriskwan88{at}gmail.com

Abstract

We present a case study of a 61-year-old Vietnamese woman who presents with features of dermatomyositis (DM), including Gottron’s papules, heliotrope rash, cutaneous ulcers, generalised weakness and pain, and weight loss with normal levels of creatine kinase (CK). She demonstrated features of interstitial lung disease and subsequently tested positive for anti-melanoma differentiation-associated gene 5 and anti-small ubiquitin-like modifier 1 activating enzyme antibodies, which belong to a DM subtype known as clinically amyopathic dermatomyositis and do not present with raised CK. She received standard treatment for DM, including oral prednisolone, hydroxychloroquine, mycopheonlate and topical betamethasone. The treatment successfully reversed skin changes; however, the patient remained generally weak and unable to carry out her activities of daily living.

  • general practice / family medicine
  • rheumatology
  • dermatology
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bcr-2019-232260

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    Footnotes

    • Contributors Supervised by SM, HB and IAS. Patient under the care of SM and HB. Report written by CK, SM, HB and IAS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.