Beyond the Skin and Muscles: Left Ventricular Dysfunction in Dermatomyositis

Background: Dermatomyositis, a rare autoimmune and degenerative disease affecting both muscles and skin, often presents with insidious and acute symptom onset.This systemic autoimmune disorder is exceptionally uncommon, with limited reported cases.Distinguishing features of dermatomyositis include a reddish-purple rash around the eyes, papules on the knuckles, and a V-shaped rash on the upper back and chest.Clinical presentations can vary, and the disease can also impact the heart, lungs, and gastrointestinal system, with cardiac involvement posing a significant source of morbidity and mortality.Case Report: We present the case of a previously healthy 26-year-old male patient who complained of a blackish-red rash on his forearm, malar area, and difficulty in rising from a seated position.Muscle biopsy findings revealed mild perimysium and endomysium inflammation, and his myositis profile indicated Mi 2+ antibodies, confirming the diagnosis of inflammatory dermatomyositis.Treatment commenced with oral steroids and azathioprine.Laboratory investigations revealed anemia of chronic illness, low normal creatinine levels, and severe hypoalbuminemia.Additionally, a 2D echocardiogram demonstrated new-onset cardiomyopathy with moderate left ventricular dysfunction.The patient was managed with diuretics, Angiotensin Converting Enzyme inhibitors, and Beta-blockers, resulting in a noticeable improvement in his condition.Conclusion: Timely initiation of therapy, guided by early detection of cardiac muscle inflammation, holds the potential to mitigate disease severity and reduce associated mortality in dermatomyositis patients.