Para além do diagnóstico!

introduction: dermatomyositis is an inflammatory and autoimmune disease with unknown etiology. these disorder presents as symmetric, proximal muscle weakness and typical skin rash. the first symptoms are uncharacteristic and can delay the clinical suspicion and referencing to secondary care. case description: report the case, of a 35 years age woman whose disease installed throughout four months. presenting initially with respiratory and systemic symptoms (fever, malaise, weight lost) preceding the muscle-skeletal (arthralgia, muscle weakness and pain). the skin rash appears after de diagnosis, 6 month later the first symptoms. comment: by reporting the case of a rare and disabling disease, we pretend to approach some aspects in which the family physician can play a key role. in clinical suspicion, referencing to secondary care, screening complications, secondary effects of treatment and approaching the individual and family as a whole.