[Amyopathic dermatomyositis].

Abstract

Dermatomyositis represents a progressive autoimmune disease of the connective tissue with SLE-like dermatitis, with inflammatory myopathy and muscular weakness. It is an infrequent and serious disease affecting not only the skin and striated muscle. Cases without skin affection are classified as polymyositis. Beside autoimmune mechanisms, aetiology includes also genetic, environmental and paraneoplastic factors. Clinical skin symptoms as well as histopathological findings include Gottron's papulae, heliotropic periorbital erythrema, which, together with palpebral oedema, brings about the weepy look of patients. None of these signs is pathognomic and beside the cutaneous symptoms the diagnosis requires 3 out of 4 other diagnostic criteria for the muscle symptoms. Cutaneous symptoms can precede myositis with various time intervals; such situation is sometimes classified as Amyopathic dermatomyositis (ADM), dermatitis sine myositis or skin dermatomyositis. A case of an ADM patient and the analysis of problematic including the strategy of therapy are presented.