LAUSR

Dear Editor, Dermatomyositis skin lesions are often refractory to various therapies. Anti-tumor necrosis factor alpha (TNF-α) treatments, including infliximab, are now widely used for the treatment of autoimmune diseases, such as rheumatoid arthritis. Here, we report a case of amyopathic dermatomyositis associated with rheumatoid arthritis in which both joint and skin symptoms were successfully treated with infliximab. A 44-year-old woman developed itchy erythema all over her body for 1 month. At her initial visit to our hospital, physical examination showed periungual erythema, nailfold bleeding, papules on the extensor surfaces of the fingers and hands (Gottron's papules), erythema on her upper chest (V-neck sign), erythematous papules on the forehead, and scratch dermatitis on her back (Figure 1). Muscle pain and weakness were not apparent. Laboratory findings were as follows: creatine kinase, 64 U/L (45–176 U/L); C-reactive protein, 0.02 mg/dL (<0.3 mg/dL); anti-Jo-1 antibody, <1.0 U/mL (<10 U/mL); and anti-aminoacyl-tRNA synthetase antibodies were negative. Whole body computed tomography, gastrofiberscopy,