Dermatomyositis is an inflammatory myopathy with a known association with malignancies and can present as part of a constellation of paraneoplastic processes.1 Typical signs and symptoms include proximal muscle weakness associated with characteristic rashes such as heliotrope rashes, shawl sign and Gottron's papules.1 Typical laboratory abnormalities include elevated CRP and CK but in the palliative setting these findings may present atypically. Here, CRP is linked to myopathy.