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Case Reports in Rheumatology
Volume 2014 (2014), Article ID 979856, 3 pages
Case Report

Unilateral Heliotrope Rash in Juvenile Dermatomyositis: An Unusual Presentation of an Underlying Serious Disease

1Division of Rheumatology, Department of Medicine, College of Medicine, King Khalid University Hospital, King Saud University, P.O. Box 2925, Riyadh 11461, Saudi Arabia
2Division of Rheumatology, Department of Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
3Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Received 21 October 2014; Accepted 1 December 2014; Published 22 December 2014

Academic Editor: Tsai-Ching Hsu

Copyright © 2014 Ghada Al-Janobi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Heliotrope rash is one of the characteristic skin manifestations of juvenile dermatomyositis. It is a reddish-purple rash on the upper eyelids that is usually bilateral. Case Presentation. We report a boy who presented with unilateral heliotrope rash, Gottron’s papules, and muscle weakness. Muscle biopsy was consistent with inflammatory myositis. Patient was started on prednisolone and methotrexate with an excellent response in both the skin and muscles. Conclusion. Unilateral heliotrope rash can occur in patients with juvenile dermatomyositis. Being a paraneoplastic condition caution should be taken not to miss any underlying malignancy.