Acute Dermatomyositis. Presented by Dr. R. C. Miller.
A Greek man, age 67, was in excellent health until four weeks prior to admission when he noted puffy eyelids and redness of the skin around both eyes, over the bridge of the nose, and the articular surfaces of the hands and wrists. One week later, he was unable to lift the 75 pound boxes that he previously lifted with ease. He noted similar weakness in his thighs and shoulders with pain and tenderness in both areas.
Heliotrope coloration, edema, and telangiectases were seen in a butterfly pattern involving the skin around both eyes, and across the bridge of the nose. The skin over the knee, elbow, foot, and especially the metacarpophalangeal joints demonstrated a dusky erythema and scaling. At the base of the fingernails, there were vertical linear telangiectases and a heaping up of cuticular skin. The shoulder and