2006 Volume 2006 Issue Supplement117 Pages 111-114
Dermatomyositis is an autoimmune disease characterized by symmetric muscular weakness of the proximal extremities and characteristic eruptions. We encountered a 17-year-old female patient in whom dermatomyositis presented with dysphagia. She experienced a sensation of ear blockage, pharyngeal discomfort and an articulation disorder. The articulation disorder gradually deteriorated and swallowing was also affected. A fiberscopic study confirmed dysphagia accompanied by characteristically impaired pharyngeal clearance of bolus, suggesting dermatomyositis. However, the diagnosis could not be confirmed due to the absence of physical findings indicating myositis and skin eruptions. After a period of remission, Gottron's sign and interstitial pneumonia were confirmed. The patient was therefore diagnosed with dermatomyositis at this stage, a period of 15 months from onset.
The present case illustrates that the disorder m a y be difficult to diagnose as dermatomyositis. It is important to conduct long-term follow-up of patients with deteriorating articulation disorder or swallowing disorder, even when myositis or skin eruptions are absent.
