key: cord-1015787-m57whld0
authors: Borges, Nicolas Henrique; Godoy, Thiago Mateus; Kahlow, Bárbara Stadler
title: Onset of dermatomyositis in close association with COVID-19 - a first case reported
date: 2021-03-23
journal: Rheumatology (Oxford)
DOI: 10.1093/rheumatology/keab290
sha: 4decf0a99c5bd5518929b6142b9325fe693aa93f
doc_id: 1015787
cord_uid: m57whld0

nan

A 36-year-old woman diagnosed with COVID-19 after presenting with a dry cough, sore throat, asthenia and fatigue. After 15 days of infectious condition and disappearance of the symptoms, she presented hyperemic lesions and itching at the root of the left thigh. It progressed to the patient's right back and thigh, followed by the hands, elbows and knees, being handled as an allergic condition. Two months after, there was an inability to perform exercises associated with tiredness and night awakenings due to pain and Raynaud's presence. On examination, the dorsum of the hand showed Gottron's papules, characterized by multiple erythematous and hyperkeratotic lesions over the interphalangeal and metacarpophalangeal joints, without the involvement of the interphalangeal skin (Image A). Her proximally muscle power was 4/5 bilateral on the upper and lower limbs. Laboratory antibodies showed positive fine speckled pattern ANA (1/640) and anti-Mi2, associated with significant increase of muscle enzymes (creatinine phosphokinase 3518U/l). Skin biopsy showed lamellar keratosis with foci of vascular changes in the epidermal layer and dilated vessels with a thickened wall and perivascular lymphocytic infiltrate, consistent with the diagnosis of dermatomyositis.1,2 The patient improved with a 5-day pulse of methylprednisolone. To our knowledge, this is the first reported case of an DM in close association with COVID-19.

Inflammatory Muscle Diseases

Dermatomyositis, and Inclusion-Body Myositis