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Dermatomyositis — RACP Adult Medicine MCQ

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ModerateRheumatologyDermatomyositisRACP Adult Medicine

A 48-year-old woman presents with a heliotrope (violaceous) rash around the periorbital region and erythema over the upper chest (V-sign). She has proximal muscle weakness and an elevated CK. Anti-Mi-2 antibody is positive. What is the most likely diagnosis?

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Correct answer: C — Dermatomyositis

Heliotrope rash (periorbital violaceous erythema), V-sign (erythema over upper chest), Gottron papules, proximal weakness, and elevated CK is classic dermatomyositis. Age-appropriate malignancy screening is essential. Treatment is prednisolone with steroid-sparing agent (methotrexate, azathioprine, or mycophenolate).

Reference: Bohan and Peter DM/PM Criteria; ACR/EULAR 2017 IIM