Refractory dermatomyositis-systemic lupus erythematosus overlap syndrome and response to tofacitinib

Dermatomyositis is an autoimmune condition that commonly presents in the form of an overlap syndrome with other rheumatic diseases. The overlap between syndromes with highly variable symptomology makes treatment difficult. We present a case of a 39-year-old woman who presented with a facial rash, arthralgias, and lower-extremity edema and steadily progressed to develop severe proximal muscle weakness and hair loss over the course of a 2.5-month hospitalization. After diagnostic testing, she was found to have a dermatomyositis-systemic lupus erythematosus overlap syndrome. Her symptoms were refractory to initial medical management but finally resolved once she was switched to tofacitinib.