Management of a Periodontal Patient With Dermatomyositis: A Case Report.

INTRODUCTION: Dermatomyositis is an uncommon inflammatory disease marked by muscle and joint weakness with skin rash. Dermatomyositis affects adults and children, with higher prevalence for females 40-60 years old. Most common oral lesions include mucosal edema, erythema and telangiectasia. CASE PRESENTATION: A 51-year-old Caucasian female with an unremarkable medical history presented for periodontal evaluation in 2010. She reported a 6-month history of gingival inflammation and skin irritation on her hands and a rash on the center of her chest and forehead. Other complaints included fatigue, hot flashes, decreased appetite, and weight loss. Periodontal examination revealed generalized acute marginal erythema, with localized slight incipient bone loss. Oral hygiene was deemed good to fair. Oral hygiene instructions were reviewed and a prescription for chlorhexidine gluconate was given. The patient was then referred to allergist and dermatologist where a diagnosis of Dermatomyositis was made. After the initial diagnosis, localized SRP was performed using local anesthetic. The patient was managed medically using Prednisone, Mycophenolate mofetil and Methotrexate and a 3-month periodontal maintenance recall interval. The patient remained stable over eight-years. CONCLUSION: Dermatomyositis is an uncommon inflammatory disease that requires medical and dental teams for proper diagnosis and management. Although the condition is chronic in nature with no definitive cure, signs and symptoms can be managed with steroids and immunosuppressants to delay progression of the disease and improve quality of life for the patient. This article is protected by copyright. All rights reserved.