CASE REPORTS   

Esperienze Dermatologiche 2009 March;11(1):17-22

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English, Italian

Paraneoplastic dermatomyositis: a case study

De Giacomo P., D’Amico D., Ferri R., Valenti G.

Unità Operativa di Dermatologia, Azienda Ospedaliera “Pugliese Ciaccio”, Catanzaro

Dermatomyositis (DM) is a degenerative inflammatory disorder that mainly affects skin, striated muscles and blood vessels. Five clinical forms of the disorder have been described: idiopathic polymyositis (PM), idiopathic DM, paraneoplastic PM/DM, juvenile DM and PM/DM associated with other connective tissue diseases. The authors report the case of a 59-year-old man who presented erythematous lesions on the face, on the extensory surface of his fingers and in the periungual region, and who for some time had reported ingravescent asthenia, myalgia in the region of the shoulder girdle muscles and progressive weight loss. The patient underwent numerous tests which showed an increase in muscle enzymes (CPK, aldolase, GOT, GPT) and myoglobin, as well as higher tumour markers (CEA, aFP, TPA, CYFRA, chromogranin A, NSE, ferritin). Total body computed tomography (CT) showed neoformations probably of a repetitive nature in the liver, lungs, cerebral parenchyma and cerebellum, and the biopsy of a hepatic lesion was positive for hepatic metastases from undifferentiated small cell carcinoma (microcytoma). A diagnosis was made of paraneoplastic DM associated with metastatic pulmonary microcytoma.