Background: Periorbital edema can occur in dermatomyositis, which is characterized by symmetric macular erythema, Gottron's papules, Gottron's sign, periungual telangiectasia, heliotrope rash, and poikilodermatous macules on the shoulders, arms, or upper back (shawl sign).
Case Report: We report the case of an 81-year-old man with dramatic periorbital edema. It was not until he was hospitalized with dysphagia 6 months after developing the edema that the diagnosis of dermatomyositis was considered.
Results: Laboratory tests, skin biopsy, and electromyography resulted in a diagnosis of dermatomyositis.
Conclusions: Periorbital edema may appear as the presenting cutaneous manifestation of dermatomyositis.
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