Childhood dermatomyositis recurring in adulthood half a century later

A 62-year-old woman presented to the emergency department with malaise, lethargy and proximal muscle weakness. She had a similar presentation in childhood. A muscle biopsy was inconclusive, however, she was treated for a presumptive diagnosis of inflammatory myositis. In a second flare in childhood, she developed proximal muscle weakness and calcinosis cutis. A muscle biopsy was consistent with juvenile dermatomyositis. She was treated with corticosteroids, however, she relapsed again 1 year later, requiring a prolonged course of corticosteroids, which led to remission and treatment was subsequently stopped. She remained well for 30 years without any relapses, however, at the age of 40 she was diagnosed with malignant melanoma, treated with local excision and radiotherapy. She had a further period of 22 years in good health, until her current presentation, with a relapse of dermatomyositis, 52 years after the last flare. She is currently in remission following successful immunosuppressive therapy.