Dermatomyositis with tuberculous fasciitis

A case of dermatomyositis with tuberculous fasciitis is described. A 69-year-old Japanese man treated with prednisolone for dermatomyositis developed erythema and bilateral swelling of arms and forearms. A diagnosis of tuberculous fasciitis was confirmed by the presence of acid-fast bacilli in a biopsy specimen and the growth of Mycobacterium tuberculosis from tissue cultures. The unusual presenting clinical features resulted in delayed diagnosis. We emphasize that tuberculous fasciitis should be considered in an immunocompromised patient who is treated with steroids, especially if the results of initial treatment are not satisfactory.