Diagnosis of Thyroid Neoplasm-Associated Dermatomyositis in Ethiopian Woman

Abstract

Gebrehiwot Lema Legese,1 Yeabsira Aklilu Tesfaye,1 Eleni Ayele,1 Desalew Getahun Ayalew,1 Aron Girma Abebaw,1 Tiruzer Bekele Gurji,2 Abilo Tadesse1 1Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Pathology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Desalew Getahun Ayalew, Email [email protected]: Dermatomyositis is an inflammatory myopathies causing proximal muscle weakness accompanied by muscular inflammation and skin rash. Dermatomyositis patients have a higher incidence of malignancy as compared to the general population.Case Report: A 52-year-old known female patient with a toxic multi-nodular goiter presented with insidious onset of itchy erythematous rash on her neck and bilateral hands and progressive muscle weakness of 4 months’ duration. Associated with this, she had photosensitivity, and periorbital edema of 2 months’ duration. On physical examination, she had an anterior neck mass, proximal muscle weakness, periorbital edema, and violaceous skin rash on her bilateral arms, shoulders and neck. Thyroid function tests were normal, creatinine kinase was elevated, and muscle biopsy revealed inflammatory myositis. Ultrasound of the anterior neck mass and analysis of fine needle aspiration suggested thyroid cancer.Conclusion: A high index of clinical suspicion is usually required for early diagnosis of dermatomyositis in resource-limited settings in order to prevent adverse outcomes and identify associated malignancies.Keywords: dermatomyositis, thyroid neoplasm, para-neoplastic syndrome, Ethiopia, Gondar

Keywords

• dermatomyositis
• thyroid neoplasm
• para neoplastic syndrome
• ethiopia
• gondar