Why is dermatomyositis considered an emergency?

Dermatomyositis can develop rapidly with significant mortality. Skin findings in this disease can predate significant muscle involvement and be quite helpful in early diagnosis and treatment, especially in children. The skin findings that are helpful in diagnosis are

• Gottron’s papules, occurring over the dorsa of the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints of the hands
• Swelling and “heliotrope” erythema of the eyelids
• Periungual erythema (erythema around the proximal nail fold)