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Dermatomyositis — SCE Rheumatology MCQ

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EasyConnective tissue diseasesDermatomyositisSCE Rheumatology

A 59-year-old woman develops heliotrope rash, Gottron papules and proximal weakness over eight weeks. CK is 2,600 IU/L, EMG is myopathic and muscle MRI shows oedema. She has lost 5 kg and has new iron-deficiency anaemia. What is the most important complication to screen for?

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Correct answer: A — Underlying malignancy

Adult-onset dermatomyositis, particularly with systemic symptoms and anaemia, is associated with malignancy and warrants age-appropriate and symptom-directed cancer screening. Cervical myelopathy and renal artery stenosis do not explain the rash and myositis pattern. The pearl is that myositis-specific antibodies and clinical phenotype can refine malignancy risk.

Reference: BSR idiopathic inflammatory myopathy guideline 2022