Can anyone tell me diseases with spike in CPK and rash associated?

Question

Three times, I've had episodes where my CPK enzyme levels have spiked (1400 the first time, 1100 the second. No test on the third).
This is associated with a rash on my upper torso and lower face. (looks like small surface hemmoraging. There's no inflammation around the initial points, and no itching)

These episodes have happened at different times of the year, while I was on different diets, and there was no pesticide spraying within 2 blocks of my residence (by a professional lawn care company or municipality)

My doctor has eliminated a whole bunch of posabilities, but we haven't been able to come up with anything that matches. Any new avenues of research would be greatly appreciated.

Answer 1

Did you have muscle weakness, especially the upper arms and upper legs? If so, you are likely to have dermatomyositis. Even if you never had the "heliotrope rash" around your eyelids, the rash sounds like the "shawl sign" seen in dermatomyositis, which is described as "Poikiloderma (spotty skin) may occur on exposed skin, such as the extensor surfaces of the arm, and may appear in a V-shaped distribution over the anterior neck and upper chest and back (ie, shawl sign). With the exception of the heliotrope rash, the eruption of dermatomyositis is photodistributed and photoexacerbated."

The elevation of your CPK means muscle injury or inflammation of some kind. For it to recur three times means something is up with your muscles. The association of a rash with each of those makes dermatomyositis very high on the list, and the shawl sign makes it even more likely.

See an internist or rheumatologist, since dermatomyositis is often associated with other important helath problems, especially if youre over 50 years.