Clinical, Serologic and Immunogenetic Studies in Patients With Dermatomyositis

Factors Predicting Malignancy in Patients with Polymyositis and Dermatomyostis: A Systematic Review and Meta-Analysis

“…The estimate for the five studies[20], [27], [31], [36], [37] involving DM patients only was 1.24 (95% CI: 0.76 to 2.02).…”

Malignancy screening in autoimmune myositis among Australian rheumatologists

“…These include age, gender, antibody status, inflammatory marker titre, resistant or recurrent myositis and certain concurrent organ/tissue manifestations. 4,[17][18][19][20][21][22][23] There are authors who believe that risk factors such as these should be considered in the cancer screening strategy. 1 Four separate meta-analyses by Wang et al, Qiang et al, Lu et al and Trallero-Araguas et al have examined this issue in depth and we report their findings.…”

“…Respondent feedback revealed the following themes on the subject of non-conduct of malignancy screening: (i) an absence of high-quality literature to support the practice, (ii) professional experience of a lack of clinical utility of the practice and (iii) suspected literature bias (Table 3). • 'A good history will lead to specific screening rather than submit every patient to a standard battery of tests in a shotgun approach' [28] • 'Increasingly I am now doing PET scans as usual screening has missed malignancy subsequently found on PET' [11] • 'Highly variable depending on History / Examination / Age / Ethnicity and disease features' [20] Theme: Triggers for initial screening • 'Especially NXP2' [55] • 'Only if response to treatment tapering is poor' [47] • 'When patients present with specific antibodies screening is not required.' [40] • '…Screening in inclusion body myositis is also favoured…' [35] Themes: Triggers for repeat screening • '…subtypes more commonly associated with malignancy eg Tif1… would guide me to be more proactive… if initial screening tests are negative' [52] • 'This is often risk driven / therapy driven and patient recovery status' [5] • 'The patient is often under regular review, any focal symptoms are followed up without delay' [30] • 'I will rescreen if there are warning bells' [12] • 'I would consider repeat screening if unexpected relapse' [11] Theme: Approach to repeat screening • '…little or no evidence to support present practice of repeated tests.…”

Dermatomyositis associated with malignant melanoma—A marker of poor prognosis?

“…29,[32][33][34][35][36][37][38] Until now, it has not been possible to identify clear-cut clinical or laboratory risk factors that could help to distinguish idiopathic DM from the paraneoplastic form. 34,39 Older age at onset, male gender, and serum CPK levels have been proposed as indicators of increased risk for cancer in adult DM. 34,[39][40][41][42] Cutaneous necrosis has also been suggested as a predictive sign for malignancy.…”

“…34,39 Older age at onset, male gender, and serum CPK levels have been proposed as indicators of increased risk for cancer in adult DM. 34,[39][40][41][42] Cutaneous necrosis has also been suggested as a predictive sign for malignancy. 27,34,43,44 However, in the patients of our literature study, cutaneous necrosis was never reported.…”