TIF1-gamma associated dermatomyositis with extensive cutaneous involvement

A 72-year-old woman with biopsy-proven treatment refractory dermatomyositis presented in November 2023 for continued management of significant cutaneous involvement and pruritus.Symptoms initially presented six years prior in 2017.Review of systems was negative for muscle weakness, and she had completed age-appropriate cancer screenings with the exception of cervical cytology.Physical examination was remarkable for photodistributed erythematous to violaceous plaques on the scalp, upper extremities, and trunk (Figure 1).She was positive for the anti-TIF1- antibody.A subsequent CT scan of the chest, abdomen, and pelvis was unremarkable for evidence of malignancy.In October 2024, marked improvement of poikilodermatous erythema and pruritus were achieved with mycophenolate mofetil and intravenous immunoglobulin (IVIG).