Let's move on to dermatomyositis.
So this is a disease afflicting generally patients who are a
bit older than our patient, generally over the age of 50.
It's associated with proximal muscle
weakness of the arms and the legs.
There's a number of different skin
manifestations that we may find,
Gottron's papules are shown here,
one of the classic manifestations.
The shawl sign or the V-sign which
is shown here as well on the right.
Then there's this heliotropic rash.
Now our patient does have this rash over
the zygomatic processes of the face.
It's not really going on around the eyes, however,
even though we do have some evidence of blepharitis.
More importantly, if a patient was being considered for
dermatomyositis, we really should have some myositis.
And we're not getting any of that sort of picture
nor any other manifestations of this disease.
Moreover, the facial rash of dermatomyositis lacks
that bright erythema that we're seeing in our patient.
Either way, we can keep that one on our list but again, I
think it's a little bit lower down in our differential.
Alright, seborrheic dermatitis.
This is a chronic, relapsing, mild dermatitis of unknown
etiology though there are some associations with malassezia.
It's common in infants and in adults and
particularly in those who are HIV positive.
It can have a prefilection for the
scalp, behind the ears, the eyebrows,
the nasolabial folds, the upper
chest and the back, the ears,
and certainly it can be
associated with blepharitis.
Usually, these lesions are
They're scaly, flaky, somewhat itchy often
described as greasy-looking plaques.
The lesions that we're seeing in our
patient however, are more erythematous
than having this greasy appearance
of seborrheic dermatosis.
So I think we can safely take
that one off our list as well.