Subcutaneous oedema as a presenting feature of polymyositis/dermatomyositis: a poor prognostic indicator?

Widespread subcutaneous oedema is a rare presenting feature of polymyositis (PM)/dermatomyositis (DM). It was reported in the initial description of the disease by Wagner in 1877 but only nine cases have since been reported in the literature and it is not listed in standard textbooks of rheumatology. We present a further case of subcutaneous oedema as a presenting feature of dermatomyositis, briefly review the existing literature and postulate that this presentation represents a subset of the disease with a poorer prognosis.