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Dermatomyositis — RACP Adult Medicine MCQ

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EasyRheumatologyDermatomyositisRACP Adult Medicine

A 48-year-old woman presents with proximal muscle weakness, a heliotrope rash around the eyes, and Gottron papules over the MCP and PIP joints. CK is 4500 U/L. Anti-Mi-2 antibody is positive. CT chest/abdomen/pelvis shows no malignancy. What is the most likely diagnosis?

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Correct answer: A — Dermatomyositis

Proximal weakness with elevated CK, heliotrope rash, and Gottron papules is pathognomonic for dermatomyositis. Anti-Mi-2 antibody is associated with classic DM with good prognosis. Age-appropriate malignancy screening is essential as DM is associated with increased cancer risk (especially within the first 3 years of diagnosis).

Reference: ACR/EULAR – 2017 – IIM Classification Criteria; Bohan and Peter Criteria