[Livid facial erythema: marker lesion of a multi-facet systemic illness]. / Livides Gesichtserythem: Markerläsion einer Systemkrankheit mit vielen Facetten.

We present a 53 year old woman with a progressive violaceous erythema (heliotrop rash) of the face with periorbital oedema. A clinical diagnosis of dermatomyositis was proposed. Except for the cutaneous manifestation there was no further clinical evidence of systemic disease and specifically of muscle involvement. The lesions developed about six months earlier and an amyopathic dermatomyositis was diagnosed. The patient was treated with hydroxychloroquine. The risk of malignant disease is increased in primary idiopathic and amyopathic adult onset dermatomyositis. Therefore an adequate work-up is mandatory.