Dermatomyositis (DM) is a multisystem inflammatory disorder, primarily affecting skin and muscle. While it has been associated with various forms of malignancies, its association with nasopharyngeal carcinoma (NPC) is rare, with an incidence of less than 1/1000.
We report a case of a 28-year-old male newly diagnosed with nasopharyngeal carcinoma (NPC), referred to our service for a 2 month history of poikiloderma on the anterior chest and back, with associated periorbital edema, facial erythema and periungual telangiectasia. Initial diagnostic work-ups revealed a markedly elevated total creatine phosphokinase (CPK-total). The patient subsequently developed symmetric proximal muscle weakness. Electromyography study was positive for myopathy. Based on the physical examination and diagnostic findings, the patient was diagnosed with dermatomyositis (DM). Treatment with oral prednisone, topical mometasone, and photoprotection for 1 month yielded improvement of symptoms.
Patients presenting with characteristic skin findings associated with symmetric proximal muscle weakness are suspicious for DM. Increasing awareness of the association between DM and NPC can help in appropriate screening especially in patients belonging to susceptible ethnic groups. Dermatologists play an essential role in the early diagnosis, treatment, monitoring and improvement of overall prognosis.
Ty, K. & Chua, NS (2017). Dermatomyositis in a 28-year-old Filipino male with nasopharyngeal carcinoma: A case report. Journal of the Philippine Dermatological Society, 26(2), 64-66
dermatomyositis, nasopharyngeal carcinoma, paraneoplastic
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