Dermatomyositis, clinically presenting with cutaneous ulcers, with histopathologic evidence of perforating collagenosis

Abstract

Dermatomyositis is a systemic, autoimmune disease with a variety of clinical features that often include myositis and characteristic cutaneous findings. A subset of patients with dermatomyositis develop cutaneous ulcers, often in the setting of vasculitis or vasculopathy. We present a case of dermatomyositis with cutaneous ulcers that show perforating collagenosis on histopathologic examination. Acquired reactive perforating collagenosis typically occurs in the setting of diabetes mellitus, chronic renal failure, and other pruritic conditions, and this case represents a rare association with dermatomyositis, which may ultimately be helpful in elucidating the pathophysiology of this perforating disorder.