Dermatomyositis is a term used to describe polymyositis with the addition of a characteristic heliotrope rash, Gottron’s papules, and shawl sign. A heliotrope rash is a butterfly rash around the eyes, bridge of the nose, and cheeks. Gottron’s papules are papular, erythematous, scaly lesions over the metacarpophalangeal joints, proximal interphalangeal joints, and distal interphalangeal joints. Shawl sign is a rash on the shoulders and upper back, elbows, and knees. Similar to polymyositis, there is symmetric proximal muscle weakness sparing the distal musculature. Creatine kinase (CK) levels are markedly elevated, indicating muscle breakdown. The rash usually precedes the muscle weakness.