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Dermatomyositis Presenting as Vulvovaginitis.

Shelby Dickison1, Whitney Grither, Leigh Compton

  • 1Washington University in St. Louis School of Medicine, St. Louis, Missouri.

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|July 16, 2019
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Dermatomyositis, an inflammatory condition, can rarely manifest as vulvovaginitis. Early diagnosis of this rare symptom is crucial for timely malignancy screening and treatment.

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Area of Science:

  • Rheumatology
  • Dermatology
  • Gynecology

Background:

  • Dermatomyositis is a rare inflammatory myopathy associated with an increased risk of malignancy.
  • Prompt health maintenance screenings are recommended for individuals with dermatomyositis.
  • Vulvovaginitis is an uncommon presenting symptom of dermatomyositis, necessitating high clinical suspicion for early diagnosis.

Observation:

  • A 31-year-old woman presented with a decade-long history of vulvovaginitis as the initial symptom of dermatomyositis.
  • Her medical history included joint pain, myalgia, fatigue, and leukopenia.
  • Physical examination revealed a characteristic rash and mucopurulent vulvovaginitis.

Findings:

  • Biopsies from the chest, axilla, and vulva confirmed dermatomyositis.
  • Malignancy evaluation yielded negative results.
  • The patient's symptoms resolved following treatment for dermatomyositis.

Implications:

  • This case highlights the importance of considering dermatomyositis in patients with persistent vulvovaginitis.
  • Delayed diagnosis in this case underscores the need for heightened clinical awareness.
  • Early recognition of dermatomyositis presenting as vulvovaginitis is critical for initiating appropriate malignancy screening.