68-year old woman with refractory cutaneous dermatomyositis

Dermatomyositis is an idiopathic inflammatory disorder of the muscles associated with characteristic cutaneous findings. Herein we report a 68-year old woman who presented with dermatomyositis associated with painful vasculitic lesions on both hands, refractory to conventional treatment. Steroids, topical tacrolimus, antimalarials and intravenous cyclophosphamide were tried with no beneficial effect. Rituximab was also administered with no initial effect; soon afterwards, intravenous immunoglobulin was administered with good results. Some cases of cutaneous dermatomyositis may require trials of different therapies to identify the treatment regimen that produces satisfactory disease control.