Sarcoid myopathy with typical rash of dermatomyositis

A 46-year-old woman had heliotrope erythema, poikiloderma, and proximal muscle weakness. Histologic examinations of the skin were consistent with dermatomyositis. Muscle biopsy revealed numerous noncaseating granulomatous lesions within the muscle fasciculi, confirming the diagnosis of sarcoid myopathy. No granulomatous lesion could be detected clinically in other organs. A combination of this skin and muscle disorder is rare and has not been reported previously.