Oral lesions as an initial manifestation of dermatomyositis with occult malignancy

Dermatomyositis (DM) is an inflammatory disease of skeletal muscle with characteristic cutaneous features. Oral manifestations of DM have been very rarely described. This case describes a patient in whom the oral lesions were among the initial manifestations of DM. The lesions were very painful and the most distressing component of the disease in this patient. High dose systemic steroids were required to control the lesions. Investigations for an occult malignancy in this patient resulted in the identification of a non-Hodgkin's lymphoma in her right kidney. Commencement of chemotherapy rapidly resulted in complete resolution of her oral and skin lesions.