Amyopathic dermatomyositis (ADM) is a variant of dermatomyositis (DM) lacking myopathy. Though it has been argued that patients with ADM are in a “premyopathic stage” of DM, several studies show that a minority of patients with ADM develop myopathy.1- 3 Failure to recognize ADM may lead to inadequate treatment and screening for DM-associated malignant neoplasm and interstitial lung disease.3 The development of weakness in ADM may not represent progression to classic DM, and a thorough evaluation is necessary to determine its cause.