Vesiculo-bullous dermatomyositis: report of three cases.

Dermatomyositis (DM) presents with various types of skin lesions, but vesicle formation is rare. We herein present three female patients with DM who formed vesicles on the trunk and extremities. In all cases the bullous lesions appeared in parallel with increased disease activity of DM. In one case, only one large bulla within an erythematous background was found on the abdomen; the other two cases presented with a number of vesicles. Histological examination revealed marked subepidermal edema with mucin deposition in the upper dermis in all cases. Breast carcinoma and malignant lymphoma were associated in one case each. However, investigations did not reveal any malignancies in the third case. Prior reports suggest that internal malignancy is much higher in patients with vesiculo-bullous DM than in those unassociated with bullous lesions. Clinicians should be aware of vesiculo-bullous type DM.