2014 Volume 124 Issue 5 Pages 927-931
A 70-year-old man presented with edematous erythema on his eyelids and erythematous rashes on his head, ear and neck. He also had paronychial erythema and nailfold bleeding. Histopathological findings from the erythema of his neck showed dermal edema and a lymphocytic infiltration at the dermo-epidermal junction and around the small vessels in the upper dermis. Laboratory blood examination revealed high levels of creatine kinase (CK) and lactate dehydrogenase (LDH). No antinuclear antibody or anti-1 antibody was detected. A manual muscle test showed proximal muscle weakness, but there were no signs of muscle inflammation in an electromyogram and a thigh MRI. No interstitial pneumonia or malignancy was detected. We diagnosed this case as typical dermatomyositis and started prednisolone. His symptoms gradually regressed. Later, anti-TIF1 and anti-SRP antibodies were detected in his serum. The coexistence of these two myositis-specific autoantibodies is considered extremely rare; generally, an affected patient has only one myositis-specific antibody.