Rapid Progression of Dermatomyositis in an Elderly Patient With Oropharyngeal and Pulmonary Involvement: A Case Report

Dermatomyositis is a rare autoimmune condition characterized by proximal muscle weakness and distinctive skin manifestations, with increased age being a significant negative prognostic factor. This case presents a 79-year-old male who presented to the emergency department with a six-week history of fatigue, weight loss, progressive symmetrical muscle weakness, and hallmark rashes, including a heliotrope rash and Gottron papules. Despite discontinuing statin therapy, thought to be a potential contributing factor to his symptoms, his condition quickly worsened, and investigations confirmed dermatomyositis through positive autoantibodies and imaging. Treatment with corticosteroids was initiated, but he continued to deteriorate rapidly, leading to dysphagia, respiratory distress, and aspiration pneumonia, which ultimately resulted in death just 28 days after initial presentation. This case emphasizes the potential for rapid progression of dermatomyositis in elderly patients, particularly those with oropharyngeal and pulmonary involvement, and highlights the importance of early recognition and multidisciplinary management.