{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:01:20Z","timestamp":1790773280751,"version":"4.1.0"},"reference-count":12,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,12]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>A man in his late 70s presented with 6-week bilateral shoulder and hip girdle pain, morning stiffness and significant weight loss. Although polymyalgia rheumatica was initially suspected, red flag weight loss prompted referral through the 2\u2009week-wait cancer pathway with parallel laboratory and imaging assessment.<\/jats:p>\n                  <jats:p>Markedly elevated creatine kinase (&gt;5000 U\/L), proximal weakness and subtle cutaneous features raised suspicion of dermatomyositis. A CT scan then demonstrated extensive intra-abdominal and right inguinal lymphadenopathy, initially suggesting lymphoma and prompting haematology referral. Ultrasound-guided lymph node biopsy unexpectedly confirmed metastatic melanoma.<\/jats:p>\n                  <jats:p>Subsequent skin and nail examination identified a pigmented right great toe lesion, previously attributed to trauma, consistent with the primary acral melanoma. The overall picture was paraneoplastic dermatomyositis presenting as a polymyalgia-like syndrome. Corticosteroids and B-Raf proto-oncogene, serine\/threonine kinase (BRAF)\/mitogen-activated protein kinase (MEK) targeted therapy were followed by resolution of muscle symptoms and radiological response.<\/jats:p>","DOI":"10.1136\/bcr-2026-276600","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:45:21Z","timestamp":1790772321000},"page":"e276600","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Metastatic melanoma presenting with paraneoplastic dermatomyositis mimicking polymyalgia rheumatica"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4435-4363","authenticated-orcid":false,"given":"Srikanth","family":"Akunuri","sequence":"first","affiliation":[{"name":"Acute Medicine, Princess Royal University Hospital, Orpington, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8195-8960","authenticated-orcid":false,"given":"Stella","family":"Bowcock","sequence":"additional","affiliation":[{"name":"Haematology, Princess Royal University Hospital, Orpington, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7767-4492","authenticated-orcid":false,"given":"Ashir","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Acute Medicine, Princess Royal University Hospital, Orpington, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesal","family":"Doshi","sequence":"additional","affiliation":[{"name":"General Medicine, Princess Royal University Hospital, Orpington, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"2026093005451463000_19.9.e276600.1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140566"},{"key":"2026093005451463000_19.9.e276600.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03540-6"},{"key":"2026093005451463000_19.9.e276600.3","doi-asserted-by":"publisher","DOI":"10.1080\/03009742.2023.2215044"},{"key":"2026093005451463000_19.9.e276600.4","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1111\/ijd.16151","article-title":"Prognosis of melanoma-associated dermatomyositis","volume":"61","author":"Leite","year":"2022","journal-title":"Int J Dermatol"},{"key":"2026093005451463000_19.9.e276600.5","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32833f1075"},{"key":"2026093005451463000_19.9.e276600.6","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2008.609"},{"key":"2026093005451463000_19.9.e276600.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(00)90137-3"},{"key":"2026093005451463000_19.9.e276600.8","doi-asserted-by":"crossref","unstructured":"Pavlick A . 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