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Case 13 (27th Annual Uniformed Services Dermatology Seminar, 2003) DERMATOMYOSITIS-LIKE ERUPTION DUE TO ZOCOR

Twede JVT - MedPix

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Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Case 13 (27th Annual Uniformed Services Dermatology Seminar, 2003) DERMATOMYOSITIS-LIKE ERUPTION DUE TO ZOCOR

History: History: 66 y/o Hispanic male with a 5 week history of pruritic erythematous changes to the skin of his upper back, chest, arms, hands, and scalp. The eruption was accompanied by progressively severe myalgias localized to the girdle muscies of the shoulder and upper extremities. The only recent medication change was Zocor (Simvastatin) from 20 mg QD to 40 mg QD.

Findings: Laboratory: ANA negative; anti-RNP, anti-Smith, anti-Ro/La, anti-Jo antibodies negative; Hepatitis panel negative; TSH, 5.90 (slightly elevated); ESR 40 (elevated), Rheumatoid Factor, negative; Creatinine Kinase 2487 (high); LFTs, CBC, Chem 10: normal; Age appropriate cancer screening: negative (PSA, CXR, recent colonoscopy);CT Scan (Neck): 16mm supraclavicular LN on left (FNA: reactive); Fullness at base of tongue (benign per laryngoscopy done by ENT) Histopathology: The biopsy shows a vacuolar interface dermatitis with increased interstitial mucin.

Exam: Examination: Scalp: erythema with scale. Face: violaceous macules resembling early heliotrope; central facial erythema. Trunk & extremities: violaceous, indurated plaques. Hands: firm erythematous papules over joints. Fingernails: ragged cuticles and tortuous dilated capillary loops. Neuro: strength 4/5 in upper extremity/shoulder girdle musculature.

No MeSH data available.


Scalp: erythema with scale. Face: violaceous macules resembling early heliotrope; central facial erythema. Trunk & extremities: violaceous, indurated plaques. Hands: firm erythematous papules over joints. Fingernails: ragged cuticles and tortuous dilated capillary loops. Neuro: strength 4/5 in upper extremity/shoulder girdle musculature.
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MPX2426_synpic23391: Scalp: erythema with scale. Face: violaceous macules resembling early heliotrope; central facial erythema. Trunk & extremities: violaceous, indurated plaques. Hands: firm erythematous papules over joints. Fingernails: ragged cuticles and tortuous dilated capillary loops. Neuro: strength 4/5 in upper extremity/shoulder girdle musculature.


Case 13 (27th Annual Uniformed Services Dermatology Seminar, 2003) DERMATOMYOSITIS-LIKE ERUPTION DUE TO ZOCOR

Twede JVT - MedPix

Scalp: erythema with scale. Face: violaceous macules resembling early heliotrope; central facial erythema. Trunk & extremities: violaceous, indurated plaques. Hands: firm erythematous papules over joints. Fingernails: ragged cuticles and tortuous dilated capillary loops. Neuro: strength 4/5 in upper extremity/shoulder girdle musculature.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2426&req=5

MPX2426_synpic23391: Scalp: erythema with scale. Face: violaceous macules resembling early heliotrope; central facial erythema. Trunk & extremities: violaceous, indurated plaques. Hands: firm erythematous papules over joints. Fingernails: ragged cuticles and tortuous dilated capillary loops. Neuro: strength 4/5 in upper extremity/shoulder girdle musculature.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Case 13 (27th Annual Uniformed Services Dermatology Seminar, 2003) DERMATOMYOSITIS-LIKE ERUPTION DUE TO ZOCOR

History: History: 66 y/o Hispanic male with a 5 week history of pruritic erythematous changes to the skin of his upper back, chest, arms, hands, and scalp. The eruption was accompanied by progressively severe myalgias localized to the girdle muscies of the shoulder and upper extremities. The only recent medication change was Zocor (Simvastatin) from 20 mg QD to 40 mg QD.

Findings: Laboratory: ANA negative; anti-RNP, anti-Smith, anti-Ro/La, anti-Jo antibodies negative; Hepatitis panel negative; TSH, 5.90 (slightly elevated); ESR 40 (elevated), Rheumatoid Factor, negative; Creatinine Kinase 2487 (high); LFTs, CBC, Chem 10: normal; Age appropriate cancer screening: negative (PSA, CXR, recent colonoscopy);CT Scan (Neck): 16mm supraclavicular LN on left (FNA: reactive); Fullness at base of tongue (benign per laryngoscopy done by ENT) Histopathology: The biopsy shows a vacuolar interface dermatitis with increased interstitial mucin.

Exam: Examination: Scalp: erythema with scale. Face: violaceous macules resembling early heliotrope; central facial erythema. Trunk & extremities: violaceous, indurated plaques. Hands: firm erythematous papules over joints. Fingernails: ragged cuticles and tortuous dilated capillary loops. Neuro: strength 4/5 in upper extremity/shoulder girdle musculature.

No MeSH data available.