Dermatomyositis and Seborrheic Dermatitis

by Stephen Holt, MD, MS

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    00:01 Let's move on to dermatomyositis.

    00:03 So this is a disease afflicting generally patients who are a bit older than our patient, generally over the age of 50.

    00:09 It's associated with proximal muscle weakness of the arms and the legs.

    00:14 There's a number of different skin manifestations that we may find, Gottron's papules are shown here, one of the classic manifestations.

    00:21 The shawl sign or the V-sign which is shown here as well on the right.

    00:25 Then there's this heliotropic rash.

    00:27 Now our patient does have this rash over the zygomatic processes of the face.

    00:31 It's not really going on around the eyes, however, even though we do have some evidence of blepharitis.

    00:37 More importantly, if a patient was being considered for dermatomyositis, we really should have some myositis.

    00:44 And we're not getting any of that sort of picture nor any other manifestations of this disease.

    00:49 Moreover, the facial rash of dermatomyositis lacks that bright erythema that we're seeing in our patient.

    00:55 Either way, we can keep that one on our list but again, I think it's a little bit lower down in our differential.

    01:01 Alright, seborrheic dermatitis.

    01:04 This is a chronic, relapsing, mild dermatitis of unknown etiology though there are some associations with malassezia.

    01:12 It's common in infants and in adults and particularly in those who are HIV positive.

    01:18 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.

    01:30 Usually, these lesions are relatively well-demarcated.

    01:34 They're scaly, flaky, somewhat itchy often described as greasy-looking plaques.

    01:40 The lesions that we're seeing in our patient however, are more erythematous than having this greasy appearance of seborrheic dermatosis.

    01:48 So I think we can safely take that one off our list as well.

    About the Lecture

    The lecture Dermatomyositis and Seborrheic Dermatitis by Stephen Holt, MD, MS is from the course Miscellaneous Skin Disorders.

    Included Quiz Questions

    1. A predilection to the scalp, eyebrows, and nasolabial folds
    2. Proximal muscle weakness
    3. Reddish purple rash on or around the eyelids
    4. Red or violet bumps that form on the outside joints of the hand
    5. A widespread, flat, erythematous area that appears on the upper back, shoulders, and back of the neck

    Author of lecture Dermatomyositis and Seborrheic Dermatitis

     Stephen Holt, MD, MS

    Stephen Holt, MD, MS

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