Dermatomyositis: cutaneous clues to subclinical myositis

A young woman presenting with Raynaud's vasospasm and polymorphic skin rash was found to have dermatomyositis. The myositis was subclinical at the time of her initial evaluation, although biochemical, electromyographic and histologic studies confirmed muscle involvement. Proper diagnosis and treatment of dermatomyositis requires recognition of the frequent disparity between cutaneous and myopathic symptoms.