첫 증상으로 피부궤양이 나타난 소아 피부근염

Abstract

Juvenile dermatomyositis is a common idiopathic inflammatory myopathy in childhood and is characterized by symmetricproximal muscle weakness and specific cutaneous manifestations. We here report on a 12-year-old boy whopresented with violaceous maculopatches with multiple deep skin ulcerations on the right arm and lower back 4months ago. One month after the initial visit, he had difficulty climbing stairs and elevating his arms above thehead. Laboratory tests showed elevation of the serum levels of skeletal muscle enzymes, and electromyogram andmuscle biopsy indicated myopathy. Histopathological analysis of the ulceration indicated necrotizing vasculitis andcalcification. Based on these findings, his condition was diagnosed as juvenile dermatomyositis. We believe that thiscase is unique because of the difficulty in diagnosing the condition, as skin ulceration is a rare cutaneous manifestationof dermatomyositis.