SCALP INVOLVEMENT IN DERMATOMYOSITIS - OFTEN OVERLOOKED OR MISDIAGNOSED

Objective.-To characterize scalp involvement in patients with dermatom yositis.Design.-Case series. Patients.-All patients with dermatomyosit is seen in our office between 1988 and mid 1993. Patient inclusion in this study required fulfillment of three or more of Bohan and Peter's criteria for dermatomyositis. Results.-Of 17 patients with the diagnos is of dermatomyositis, scalp involvement was present in 14. Five of th e 14 patients with scalp involvement were diagnosed as having scalp ps oriasis or seborrheic dermatitis before progression of their disease o r tissue examination revealed the diagnosis of dermatomyositis. In all patients, the scalp involvement was manifested as atrophic, erythemat ous, scaly plaques. In addition, alopecia was noted in six of the 14 p atients. Treatment of cutaneous involvement included sun avoidance, to pical corticosteroids and/or antimalarials, and/or methotrexate. Concl usions.-Recognition of this process is important because scalp involve ment is often overlooked, may be misdiagnosed initially, and can be th e presenting complaint in some patients with dermatomyositis.