Dermatomyositis in association with tubulovillous adenoma: resolution after resection of adenoma.

Dermatomyositis (DM) has been associated with gastrointestinal malignancy but not with polyps or adenoma. We report a case of villous adenoma associated with DM. An 80-year-old white woman was referred for a rash of 2 months' duration that was suggestive of DM. On examination, Gottron's papules and heliotrope rash were seen. Muscle strength was 4/5 in the proximal upper and lower extremities. Despite normal muscle enzyme values, electromyographic and nerve conduction studies were supportive of the diagnosis of DM. DM was confirmed by deltoid muscle biopsy. Heme-positive stool was seen on rectal examination. Colonoscopy revealed a large tubulovillous adenoma in the cecum, which was resected. The patient was given oral prednisone, 60 mg/day. Within 4 weeks after surgery, steroids were tapered to one third the original dose. Within 9 months, steroid therapy had been discontinued with no evidence of disease activity.