DERMATOMYOSITIS

Dermatomyositis is rare in appearance and mysterious in origin. So closely does it resemble other conditions in some respects that doubt has been expressed that it is an entity. Dowling and Freudenthal,¹ after citing three cases, summarize the clinical picture of dermatomyositis. Occasional prodromes appear as patches of erythema or Raynaud-like symptoms, during which the diagnosis is impossible. Usually the condition begins with erythema and swelling of the face and eyelids, sometimes extending to other regions. This phase may last for months but is succeeded by more persistent cutaneous changes resembling lupus erythematosus and spreading from the face to the neck, thorax, shoulders, arms and elsewhere. In severe cases early and extensive muscular weakness occurs and usually acute swelling and pain. An intermittent fever is usually, although not always, found at this stage. Histologically the epidermis is thinned with diminished or absent rete pegs, sclerotic connective tissue and diminished