Bullous Dermatomyositis Associated with Gastric Carcinoma

Cutaneous manifestations of dermatomyositis commonly include Gottron's papules, periorbital heliotrope rash, periungual erythema or telangiectasia, and poikiloderma. Vesicles or bullae have rarely been reported. We describe a patient with dermatomyositis who presented with vesicles and was subsequently diagnosed as having gastric carcinoma. It is important to recognize this vesiculo-bullous variant in order to avoid a delay in diagnosis. Vesiculo-bullous dermatomyositis may be associated with a higher incidence of internal malignancy than typical dermatomyositis and portend a poorer prognosis. (Dermatol Sinica 22 : 243-247, 2004)