IntroductionWe present a relapsing case of dermatomyositis in a 73-year-old female with a severe disease phenotype involving cutaneous manifestations, severe symmetrical muscle weakness and bulbar involvement. Her case highlights factors associated with poorer prognosis. It further points to the first year post remission as being the highest risk for relapse, during the tapering of immunosuppression. She responded well to treatment with rituximab. Her case also highlights a potential viral trigger in the form of human parechovirus (HPeV), which has been highlighted previously in Japanese literature and is worthy of further consideration.
展开▼
