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Dermatomyositis with tuberculous fasciitis.
Yuichi Yoshida1, Juichiro Nakayama, Masutaka Furue
1Department of Dermatology, School of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. yyoshida@cis.fukuoka-u.ac.jp
European Journal of Dermatology : EJD
|June 16, 2004
Summary
A rare case of tuberculous fasciitis mimicking dermatomyositis in an immunocompromised patient is presented. Early consideration of this infection is crucial for timely diagnosis and treatment, especially in steroid-treated individuals.
Area of Science:
- Infectious Diseases
- Dermatology
- Rheumatology
Background:
- Dermatomyositis is an autoimmune disease affecting muscles and skin.
- Tuberculous fasciitis is a rare manifestation of tuberculosis affecting the fascia.
- Steroid therapy can mask or alter the presentation of infections.
Observation:
- A 69-year-old man with dermatomyositis on prednisolone developed arm erythema and swelling.
- Initial symptoms were atypical for dermatomyositis, leading to a diagnostic delay.
- Acid-fast bacilli and Mycobacterium tuberculosis were identified in biopsy and culture.
Findings:
- The patient was diagnosed with tuberculous fasciitis.
- The clinical presentation mimicked dermatomyositis flares.
- Microbiological confirmation was essential for accurate diagnosis.
Implications:
- Tuberculous fasciitis should be considered in immunocompromised patients on steroids with atypical presentations.
- Prompt diagnosis and treatment are vital to prevent disease progression.
- This case highlights the importance of considering unusual infections in patients with autoimmune diseases undergoing immunosuppressive therapy.