Vesiculo-bullous dermatomyositis

Cutaneous manifestations of dermatomyositis (DM) commonly include Gottron's papules, cuticular erythema and telangiectasia, periorbital edema with a "heliotrope" rash, a papulosquamous eruption of the hairline, face, and trunk, as well as poikiloderma. Very few references can be found concerning vesicular and bullous lesions, however. We present two patients with dermatomyositis who manifested vesicular and bullous lesions who were initially misdiagnosed. Although rare, it is important to recognize this form of DM to avoid misdiagnosis. Furthermore, in some cases, vesiculo-bullous DM may portend a poor prognosis.