Dysphagia and a rash
BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1590 (Published 10 May 2018) Cite this as: BMJ 2018;361:k1590
- Michael McFarlane, gastroenterology SpR,,
- Ben Disney, consultant gastroenterologist
- University Hospital Coventry and Warwickshire, Coventry, UK
- Correspondence to M McFarlane mmcf1982{at}doctors.org.uk
A 58 year old man presented with a six week history of muscle weakness, dysphagia, and a symmetrical widespread rash on the face, torso, limbs, and hands (fig 1). His creatine kinase was 7070 u/L (reference range 30-175). An oesophagogastroduodenoscopy showed abnormal findings, and a positron emission computed tomography (PET CT) scan was arranged (fig 2). What are this man’s dermatological and oesophageal diagnoses?
Dorsum of the patient’s right hand
PET CT image
Answer
Gottren’s papules (fig 1) suggest acute dermatomyositis, and the high uptake of fluorodeoxyglucose in the mid oesophagus (fig 2) suggests oesophageal …
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