DERMATOMYOSITIS (DM) is a rare idiopathic inflammatory myopathy with characteristic skin lesions. Case series have shown an association between DERMATOMYOSITIS and malignancy. Malignancy has been found in 15-25% of the adult patients with DERMATOMYOSITIS.A 50-year-old new case of breast cancer was admitted with muscle weakness and inability to walk. Physical examination revealed fever, periorbital edema, a heliotrope rash on the upper eyelids, large right-sided breast mass and erythematous plaques on the upper chest, abdomen and legs. During hospitalization, she developed a nasal speech, dysphasia, and nasal regurgitation of food and water.A clinical diagnosis of DERMATOMYOSITIS secondary to breast adenocarcinoma was made according to the skin lesions, muscle weakness, elevated ESR, and increased CPK and LDH levels. Wide spectrum antibiotics and Dexamethasone were administered but fever persisted. Although chemotherapy was recommended, she developed respiratory failure and aspiration pneumonia and died.DERMATOMYOSITIS is one of the paraneoplastic syndromes which are associated with breast cancer. Although treatment of DERMATOMYOSITIS generally includes corticosteroids with or without immunosuppressants, cancerdirected specific therapy including surgery and/or chemotherapy would be more effective. DERMATOMYOSITIS should be considered in breast cancer patients with skin lesions and muscle weakness and cancer-specific therapy should be started as soon as possible. 

Objective: Objective: Juvenile dermatomyoistis (JDMS) involves children rarely. Our purpose of this study is to detect clinical and laboratory aspects of this disorder and its treatment in Khorasan Province. Material & Methods: A 10-years retrospective study performed on medical records of all patients with JDMS in a medical center in Mashhad. Data was analyzed with statistical measures including SPSS and Excel. Findings: 18 patients had DJMS during 10 years. There was a female to male predominance (1.25/1). The mean age of patients was 12.1 years. Muscular weakness was the most common presenting symptom. Skin involvement including heliotrope rash and Gottron papules were detected in most patients. Elevated muscular enzymes were an important finding in many cases. EMG, and muscle biopsy in those cases performed, showed abnormal results. Seventeen (94.5%) of patients responded to oral prednisolon therapy.Conclusion: According to clinical manifestations and laboratory findings, in particular muscular enzyme assays, a timely diagnosis and treatment with oral prednisolon can improve the disease dramatically and reduce morbidity and mortality rates as well.

Introduction:An 8-year-old Iranian girl was referred because she had progressive muscle weakness predominantly in lower limbs since about 2 years ago. She was not able to stand from a sitting position without help and had difficulty climbing stairs. She walked slowly and could not run like before. She had no complaint of dysphagia or dysphonia.

Introduction: DERMATOMYOSITIS (DM) is an idiopathic connective tissue disease with a wide range of systemic manifestations. Progressive proximal skeletal muscle weakness and symmetric and inflammatory infiltrates are the main clinical and histological features of DM. Case Presentation: In this study, we report the case of a 43-year-old male with DM and early pulmonary manifestations. A 50 mg/g daily dose of prednisolone was administered for the case. The symptoms of muscle weakness improved after 2 weeks. Commonly, pulmonary diseases occur after the occurrence of other connective tissue diseases. However, in the present case, pulmonary manifestations were observed many years before the incidence of DM symptoms. Conclusion: The DM with pulmonary involvement is associated with worse outcomes; accordingly, a higher rate of mortality is reported among these patients. Based on the literature, the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are reliable markers for the diagnosis of DM, along with lung problems.

We report a case of clinically amyopathic DERMATOMYOSITIS (CADM) with anti-MDA5 positivity associated with rapidly progressive interstitial lung disease. The analogies between CADM-associated interstitial lung disease and coronavirus disease 2019 (COVID-19) pneumonia may hinder the diagnosis and delay the start of immunosuppressive therapy. High-resolution computed tomography revealed an evident worsening of the bilateral consolidation, interlobular septal thickening, and ground-glass opacities, highlighting the diagnosis of rapidly progressive interstitial lung disease. The radiological presentation, combined with the laboratory findings, underscored the diagnosis of CADM. In the following days, the respiratory failure progressed, and the patient required extracorporeal membrane oxygenation and lung transplantation. The typical cutaneous rash of DERMATOMYOSITIS and non-pulmonary clinical differences can help the physician reach a correct diagnosis. Assessing patients with interstitial lung diseases during the COVID-19 pandemic is difficult. Through experience with systemic autoimmune diseases such as clinically amyopathic DERMATOMYOSITIS, we can develop new pathophysiology models and therapeutic strategies for COVID-19.