General Dermatology and Dermatology in Primary Health Care

An older woman presented with a 6-week history of a progressive pruritic erythematous rash, later developing proximal weakness and severe dysphagia. Creatine kinase levels remained normal, and histology showed interface dermatitis with dermal eosinophilia. The case highlights an atypical “skin-first” dermatomyositis phenotype with systemic progression and uncommon laboratory and histological features.