Dermatomyositis (DM) is a female-predominant idiopathic inflammatory myopathy with characteristic skin manifestations. Reports of the association between DM and pregnancy are rare, although 2 types of pregnancy-related DM have been proposed: one presenting during pregnancy and the other, less common, developing post partum.1 Three case reports of the less common DM describe women who manifested symptoms of classic DM (CDM) 5, 15, and 30 days, respectively, after normal deliveries.1- 3 In addition, postpartum exacerbation was reported 3 months after delivery and during the period following a spontaneous abortion.3,4 Various triggers for pregnancy-associated DM may include exposure of the mother to fetal antigens and maternal hormonal changes.1 We describe herein a patient who developed amyopathic DM (ADM) after a spontaneous abortion, which progressed 2 years later, following the delivery of a healthy infant, to CDM.
Skin biopsy specimen of right middle finger. An interface dermatitis is shown, characterized by a patchy bandlike lymphocytic infiltrate in the superficial dermis, basal vacuolar alteration of the epidermis, and necrotic keratinocytes (hematoxylin-eosin, original magnification ×100).
Gottron papules on knuckles (A) and elbow (B).
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The Rational Clinical Examination
Make the Diagnosis: Early Pregnancy
The Rational Clinical Examination
Original Article: Is This Patient Pregnant?
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