Overlap syndrome of type Wong variant dermatomyositis and rheumatoid arthritis

Wong type dermatomyositis describes a small group of patients with dermatomyositis clinically presented with pityriasis rubra pilaris-like eruptions, including diffuse palmoplantar hyperkeratosis and follicular hyperkeratosis. Histopathologic findings include follicular hyperkeratosis and arrector pili myositis. There have been 20 cases reported since Wong's large series. We report a 56-year-old male with overlap syndrome of Wong type dermatomyositis and rheumatoid arthritis. He also fulfilled the criteria of anti-tRNA synthetase syndrome due to the presence of anti-Jo-1 antibody and clinical features of both rheumatoid arthritis and myositis. No internal malignancy was found after a complete systemic survey and within 1 year follow-up period. There was a good response to oral steroid therapy