Amyopathic Dermatomyositis Associated With Malignancy

Finger, David R.; Dunn, Cary L.; Gilliland, William R.; James, William D.

doi:10.1111/j.1365-4362.1996.tb03698.x

Cited by 16 publications

(9 citation statements)

References 9 publications

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“…ADM was not fully recognized as a distinct subset of dermatomyositis until the early 1990s 2. Initially thought to carry a favorable prognosis, ADM may in fact be linked with an increased risk of internal malignancy, as suggested by some case reports 3,4. Several studies also have indicated an increased risk of lung disease,5,6 but the extent of this risk is unclear.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Dermatomyositis and Clinically Amyopathic Dermatomyositis

Bendewald¹,

Wetter²,

Li³

et al. 2010

Arch Dermatol

274

154

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Section: Introductionmentioning

confidence: 99%

Incidence of Dermatomyositis and Clinically Amyopathic Dermatomyositis

Bendewald¹,

Wetter²,

Li³

et al. 2010

Arch Dermatol

274

154

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“…A patient with colon adenocarcinoma and a patient with bladder carcinoma received unremarkable evaluations at the onset of their cutaneous symptoms, only to be diagnosed on repeat evaluation several months later. [17] Primary malignant lymphoma of the genital tract is extremely rare, accounting for <1% of extranodal lymphomas and 0.6% of uterine cervical lymphomas. Unfortunately, cervical lymphomas arise from the stroma and not the mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…[9] Other malignancies reported with amyopathic dermatomyositis include ovarian, endometrial, and cervical cancer in women, nasopharyngeal carcinoma in Asian populations, gastointestinal malignancies, and melanoma. [4,10,11,[15][16][17][18] One review used two cases to exemplify that even microscopic foci of a tumor can mediate paraneoplastic manifestations. A patient with colon adenocarcinoma and a patient with bladder carcinoma received unremarkable evaluations at the onset of their cutaneous symptoms, only to be diagnosed on repeat evaluation several months later.…”

Section: Discussionmentioning

confidence: 99%

A Rare Lymphoma in a Patient with Amyopathic Dermatomyositis

Ledwich

Olenginski

2010

American Journal of Clinical Dermatology

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A 37-year-old Caucasian woman was evaluated for a photosensitive dermatitis. A positive anti-nuclear antibody with a titer of 1 : 1280 and a speckled pattern was noted and she was diagnosed with subacute cutaneous lupus erythematosus (SCLE). Although the initial dermatologic diagnosis was SCLE, a skin biopsy suggested the additional possibility of dermatomyositis because of increased dermal mucin. We began following her at the request of the dermatology department, and a diagnosis of amyopathic dermatomyositis was made based on the lack of objective muscle weakness, normal muscle enzymes, negative double-stranded DNA, SSA/SSB, and RNP/Smith antibody panel, and especially on the cutaneous examination findings. A malignancy evaluation included a normal CT scan of her chest, abdomen, and pelvis, esophagogastroduodenoscopy, colonoscopy, mammography, pelvic ultrasound, Papanicolaou smear, and endometrial biopsy. She developed vaginal bleeding 1 year after the onset of her skin manifestations. Repeat gynecologic evaluation, including cervical biopsy, revealed a large B-cell cervical lymphoma. Amyopathic dermatomyositis and lymphoma of the cervix are both rare conditions. Our case emphasizes the importance of considering underlying malignancy at the time of diagnosis and while the patient is followed clinically. Additionally, the clinician must remain vigilant in evaluating any new clinical changes in follow-up care. To our knowledge, this is the first documented case of lymphoma of the cervix in the setting of amyopathic dermatomyositis.

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“…It is of some concern that patients with the typical skin rash who had a complete malignancy evaluation with negative results later had evidence of neoplastic disease. In one patient with ADM, flexible sigmoidoscopy failed to show any abnormalities [34]. One year later, this patient developed enlarged lymph nodes that showed malignant cells on biopsy.…”

Section: Associations With Malignancymentioning

confidence: 95%

“…Finger et al [34] Adenocarcinoma of colon Lesion missed on initial sigmoidoscopy; found in LN 1 year later Osman et al [35] Transformed malignant lymphoma Mediastinal LN found on imaging studies of chest; biopsy showed T-cell lymphoma Fung et al [36] Nasopharyngeal carcinoma (3), unknown primary (1), non-small cell carcinoma of lung (1) Six patients with ADM reported; five males had associated malignancies Goyal and Nousari [37] Recurrent breast cancer Skin eruptions occurred after initial breast cancer diagnosis and preceded detection of recurrent disease Russ et al [38] Transitional cell carcinoma of bladder Cystoscopy 3 years before rash had negative results, but microhematuria persisted and repeat examination after skin presentation was positive for papillary tumors Lam et al [27•] Nasopharyngeal carcinoma (3), non-small cell lung cancer (1), CML (1), unknown primary (1) Muscle MRI abnormalities consistent with inflammation were present in the patient with CML; MRI studies in other patients had normal results Ang et al [39••] Nasopharyngeal (1), rectal (1) Malignancy more prevalent in myopathic than in amyopathic subset tapering of the prednisone, the rash recurred along with severe hypoxemia. The chest radiograph was consistent with adult respiratory distress syndrome.…”

Section: Of Patients) Commentsmentioning

confidence: 98%

Amyopathic dermatomyositis

Olsen¹,

Park²,

KingJr³

2001

Curr Rheumatol Rep

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Amyopathic dermatomyositis is a variant of dermatomyositis that is characterized by the typical skin rash but without the muscle abnormalities. It has been proposed that the amyopathic and myopathic forms of dermatomyositis exist on a continuum, a concept that is supported by family and genetic studies and the observation that a small proportion of amyopathic patients transform to a frankly myopathic state. The amyopathic state is defined by a lack of muscle weakness and through diagnostic tests, including serum muscle enzymes, electromyogram studies, and muscle biopsies, that are usually normal or show only minimal abnormalities. Despite the lack of weakness, many patients complain of debilitating fatigue. More sensitive measures of muscle function, such as P-31 magnetic resonance spectroscopy, suggest that muscle metabolism is abnormal in amyopathic patients. The amyopathic form is more commonly seen in adults than in children, although juvenile cases are reported. Some early series suggested no association with underlying malignancies, but recent reports indicate that malignancies occur. Determining whether a patient has amyopathic rather than myopathic disease may have prognostic implications.

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Amyopathic Dermatomyositis Associated With Malignancy

Cited by 16 publications

References 9 publications

Incidence of Dermatomyositis and Clinically Amyopathic Dermatomyositis

Incidence of Dermatomyositis and Clinically Amyopathic Dermatomyositis

A Rare Lymphoma in a Patient with Amyopathic Dermatomyositis

Amyopathic dermatomyositis

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