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Dermatomyositis — SCE Dermatology MCQ

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HardConnective Tissue & VasculitisDermatomyositisSCE Dermatology

A 40-year-old woman with dermatomyositis has periungual telangiectasia visible on nailfold capillaroscopy. What pattern of capillary change is characteristic of dermatomyositis on nailfold capillaroscopy?

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Correct answer: C — Dilated capillary loops with bushy/ramified neoformed capillaries, avascular areas, and capillary haemorrhages

The best answer is “Dilated capillary loops with bushy/ramified neoformed capillaries, avascular areas, and capillary haemorrhages”. Dermatomyositis combines characteristic cutaneous signs with inflammatory myopathy; antibody phenotype helps estimate malignancy and interstitial-lung-disease risk but must be interpreted with the clinical picture. The alternatives “Normal capillary pattern, after clinicopathological correlation, after specialist assessment, when the full phenotype supports it”, “Tortuous capillaries, after specialist assessment, when the full phenotype supports it”, “Complete absence of capillaries, when the full phenotype supports it”, “No changes visible, within an appropriate UK pathway, after clinicopathological correlation” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: BAD dermatomyositis information: https://www.bad.org.uk/pils/dermatomyositis