Scalp involvement in dermatomyositis. Often overlooked or misdiagnosed
J. S. Kasteler and J. P. Callen
Division of Dermatology, University of Louisville, School of Medicine, KY.
OBJECTIVE--To characterize scalp involvement in patients with
dermatomyositis. DESIGN--Case series. PATIENTS--All patients with
dermatomyositis 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
diagnosis of dermatomyositis, scalp involvement was present in 14. Five of
the 14 patients with scalp involvement were diagnosed as having scalp
psoriasis or seborrheic dermatitis before progression of their disease or
tissue examination revealed the diagnosis of dermatomyositis. In all
patients, the scalp involvement was manifested as atrophic, erythematous,
scaly plaques. In addition, alopecia was noted in six of the 14 patients.
Treatment of cutaneous involvement included sun avoidance, topical
corticosteroids and/or antimalarials, and/or methotrexate.
CONCLUSIONS--Recognition of this process is important because scalp
involvement is often overlooked, may be misdiagnosed initially, and can be
the presenting complaint in some patients with dermatomyositis.
