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Review of Clinical Signs Review Questions

Signs of Dermatomyositis

Authors: Prashanth Sunkureddi, MD, Tracy U. Nguyen-Oghalai, MD, and Bernard M. Karnath, MD

1. A 44-year-old woman presents with complaints of difficulty sitting up from a chair, combing her hair, and getting out of a bathtub. She has experienced these symptoms for approximately the past 3 months. She has also noticed a discoloration of her eyelids. Physical examination reveals significant weakness of her proximal muscles and a violaceous discoloration of the eyelids with periorbital edema. What is the most likely diagnosis?
  1. Polymyositis
  2. Dermatomyositis
  3. Muscular dystrophy
  4. Myasthenia gravis
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2. Skin examination of this patient also reveals roughening and fissuring of the skin on the palm and radial surface of her fingers. What is the name of this rash?

  1. Gottron’s sign
  2. Psoriasis
  3. Mechanics’ hands
  4. V-sign
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3. Which one of the following complications is associated with dermatomyositis?

  1. Renal failure
  2. Pseudohypertrophy of muscles
  3. Liver disease
  4. Interstitial lung disease
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4. In addition to the diagnostic work-up of this patient, additional evaluation should include:
  1. Malignancy work-up
  2. Esophageal manometry
  3. Magnetic resonance imaging (MRI) of the brain
  4. 24-hour urine protein collection
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5. All of the following diagnostic tests are routinely performed in the evaluation of dermatomyositis EXCEPT:

  1. Muscle biopsy
  2. Electromyographic study
  3. Serum muscle enzyme levels
  4. Magnetic resonance imaging of spine
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