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Dermatomyositis with Eosinophils
Isabella I Sanchez1, Henry O Herrera2, Ashley Elsensohn3
1School of Medicine, University of California Irvine, Irvine, CA 92697, USA.
Dermatopathology (Basel, Switzerland)
|December 22, 2023
Summary
Dermatomyositis, an inflammatory myopathy, can present with atypical skin findings. This case highlights that eosinophils in skin biopsies, though unusual, may indicate dermatomyositis, especially with intense itching.
Area of Science:
- Dermatology
- Immunology
- Pathology
Background:
- Dermatomyositis is an idiopathic inflammatory myopathy characterized by muscle weakness and distinct skin manifestations.
- Typical histopathology includes vacuolar changes, dermal mucin, and lymphocytic infiltrate.
Observation:
- A patient presented with intensely pruritic papules and plaques suggestive of dermatomyositis.
- Initial skin biopsy revealed superficial dermatitis with eosinophils, mimicking a drug eruption.
Findings:
- A subsequent biopsy showed classic dermatomyositis features: vacuolar interface dermatitis with increased mucin and no eosinophils.
- Intense pruritus correlated with skin lesions exhibiting tissue eosinophilia.
Implications:
- This case underscores the importance of considering tissue eosinophilia in the differential diagnosis of dermatomyositis.
- Recognizing atypical histopathology is crucial for accurate diagnosis and timely management of dermatomyositis.
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