The polymorphous spectrum of dermatomyositis: classic features, newly described skin lesions, and rare variants

Didona, Dario; Juratli, Hazem A.; Scarsella, Luca; Eming, Rüdiger; Hertl, Michael

doi:10.1684/ejd.2020.3761

Cited by 17 publications

(62 citation statements)

References 83 publications

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“…Rare skin lesions in DM include non-scarring alopecia, bullous eruptions, leukocytoclastic vasculitis, livedo reticularis, and erythroderma [3]. The so-called Wong-type DM, imitating pityriasis rubra, is reported casuistically [6,7].…”

Section: Obwodowy Zanik Włókien Mięśniowych 19 -mentioning

confidence: 99%

“…Kazuistycznie opisywanym wariantem DM jest tzw. postać Wonga, imitująca łupież czerwony mieszkowy [6,7].…”

Section: Zmiany Skórneunclassified

“…Chorym z postacią amiopatyczną DM bez zajęcia płuc należy zalecić przede wszystkim ścisłą fotoprotekcję, leczenie miejscowe (GKS lub inhibitory kalcyneuryny), leki przeciwświądowe i przeciwmalaryczne. Efekty leczenia hydroksychlorochiną skórnych objawów DM są jednak Dermatology Review/Przegląd Dermatologiczny 2021/2 tients [6]. Drugs recommended for the treatment of DM are discussed below.…”

Section: Leczenieunclassified

“…In more severe cases, especially with a more intense muscle involvement, administration of 3 to 5 intravenous pulses of methylprednisolone, 1000-1500 mg each, it is recommended, and continuation of the therapy with the maintenance dose of oral GCs, gradually lowered as the clinical symptoms disappear [1,6]. If no improvement is observed in the period of about 12 weeks of GC monotherapy, it is advisable to add an immunosuppressive drug [6]. It seems that early administration of immunosuppressive treatment improves the results of therapy and allows for a reduction of the cumulative dose of glucocorticosteroids.…”

Section: Systemic Glucocorticosteroidsmentioning

confidence: 99%

“…The factor significantly limiting the use of glucocorticoids is the high risk of side effects. Medical consequences in patients with DM are often not caused by disease complications, but by side effects of GCs, which include, among others, sterile bone necrosis, steroid myopathy and vertebral osteoporotic fractures [1,6].…”

Section: Systemic Glucocorticosteroidsmentioning

confidence: 99%

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Dermatomyositis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society

Reich¹,

Lis‐Święty²,

Krasowska³

et al. 2021

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Dermatomyositis is an autoimmune disease characterized by skin lesions and/or symptoms of myositis. In addition to the so-called classic dermatomyositis the following forms of dermatomyositis are distinguished based on the clinical presentation: pediatric, paraneoplastic, drug-induced and amyopathic. A number of disease-specific autoantibodies are identified in dermatomyositis (including anti-Mi2, anti-TIF1, anti-NXP2, anti-SAE or anti-MDA5), presence of which may be associated with a specific clinical phenotype. The diagnosis of the severity of muscle involvement is currently based mainly on physical examination, deviations in results of laboratory investigations, electromyographic examination and imaging examination, mainly with the use of magnetic resonance imaging. Systemic glucocorticosteroids administered as monotherapy or in combination with other immunosuppressants remain the mainstay of dermatomyositis treatment, and in the absence of satisfactory improvement, intravenous immunoglobulins are used. In addition, in case of interstitial lung disease, the use of cyclophosphamide may be necessary. The choice of a therapy, as well as the rate of dose reduction, depend on the dynamics of the disease, symptoms, diagnosed immunological disorders, as well as comorbidities and the drugs used. Each diagnostic and therapeutic decision must take into account the individual clinical data of the patient and current scientific reports.

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Section: Obwodowy Zanik Włókien Mięśniowych 19 -mentioning

confidence: 99%

“…Kazuistycznie opisywanym wariantem DM jest tzw. postać Wonga, imitująca łupież czerwony mieszkowy [6,7].…”

Section: Zmiany Skórneunclassified

Section: Leczenieunclassified

Section: Systemic Glucocorticosteroidsmentioning

confidence: 99%

Section: Systemic Glucocorticosteroidsmentioning

confidence: 99%

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Dermatomyositis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society

Reich¹,

Lis‐Święty²,

Krasowska³

et al. 2021

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Case report: Successful treatment of anti‐MDA5‐positive to negative dermatomyositis‐associated interstitial lung disease with the JAK inhibitor tofacitinib

Jiang

Yao

Tang

et al. 2023

Immunity Inflam & Disease

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Objective: Anti-MDA5 antibody-positive dermatomyositis (DM) is a rare clinical autoimmune disease, and anti-MDA5-positive DM with interstitial lung disease (ILD) is the most important cause of death in DM patients. We reported the efficacy of the JAK1/3 inhibitor tofacitinib as an anti-MDA5negative treatment option for patients with anti-MDA5-positive DM-ILD. Method and process: Here we report a 51-year-old female patient with cough, sputum, shortness of breath for 5 months, rash for 3 months, and muscle pain in the extremities for 1 month. After conventional immunosuppressive therapy plus hormone therapy, the remission was slow.Methylprednisolone was successfully reduced after we administered tofacitinib and tacrolimus. After 132 weeks of follow-up, anti-MDA5 antibody turned negative, clinical symptoms were relieved, and lung Imaging tests were successfully reversed. Results and Conclusion:There is currently no report of tofacitinib supplement therapy for anti-MDA5 positive to negative DM. With this case report, tofacitinib is an option for the treatment of anti-MDA5-positive DM-ILD, which deserves attention.

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Dermatomyositis and Other Autoimmune Disorders

Eming¹,

Didona²

2021

Braun-Falco´s Dermatology

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The polymorphous spectrum of dermatomyositis: classic features, newly described skin lesions, and rare variants

Cited by 17 publications

References 83 publications

Dermatomyositis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society

Dermatomyositis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society

Case report: Successful treatment of anti‐MDA5‐positive to negative dermatomyositis‐associated interstitial lung disease with the JAK inhibitor tofacitinib

Dermatomyositis and Other Autoimmune Disorders

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