I first started caring for patients with dermatomyositis (DM) skin disease under the guidance of James N. Gilliam, MD, while serving as an immunodermatology research fellow in the Department of Dermatology at UT Southwestern Medical Center in Dallas, Texas, in 1976. Among the patients I encountered working with him were individuals who for atypically prolonged periods (>6 months) displayed hallmark cutaneous lesions of DM as an isolated clinical finding. That such patients had not developed the expected systemic manifestation of proximal muscle weakness during this time frame made them unusual. At that time, such patients were commonly referred to by dermatologists as having “DM sine myositis.” Such patients were not then recognized by nondermatologists at that time as having a form of DM because they did not meet the Bohan classification criteria for DM.1,2
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