Clinically amyopathic dermatomyositis: clinical features, response to medications and malignancy‐associated risk factors in a specific tertiary‐care‐centre cohort

Abstract

CADM represents a significant subset of the DM population. As with classic DM, the cutaneous manifestations of CADM often represent a therapeutic challenge. A subset of patients with CADM has underlying malignancies, and these may differ from those typically associated with classic DM. Differences in serological abnormalities, cutaneous manifestations and response to first treatment among patients with CADM with and without malignancy were found, and suggest distinct pathophysiologies among CADM subsets. Characterization of this cohort expands the knowledge about this unique DM subset.

Treatment of a case with anti-MDA5 antibody positive clinically amyopathic dermatomyositis complicated with stomach cancer and colon cancer

“…The DM and CADM patients with malignancy were older and had a higher incidence of dysphagia, and the incidence of ILD, heliotrope rash, Gottron's sign, periungual erythema, cutaneous necrosis, and flagellate erythema were lower in those with malignancy than those without [2,7] . Although she was elderly, she had generally poor findings which suggested complication with malignancy.…”

“…CADM accounts for 12.8%-37.8% of all DM [2][3][4]7] . In Japan, the anti-MDA5 antibody, which is one of the MSAs, is observed in 10.9%-25.6% of DM patients [2][3][4] and 53.3%-66.7% of CADM patients [4,5] .…”

“…It is one of the MSAs and is associated with IP, which may result in a poor prognosis. Malignancy is observed in 7.6%-32.7% of DM patients [2][3][4] and in 0-28.6% of anti-MDA5 antibody-positive cases [2,4,[5][6][7] . We report a case of anti-MDA5 antibody-positive CADM complicated with stomach cancer and colon cancer.…”

Drs. Cao and Zheng reply

“…The prognosis of patients with ulcerative Gottron papules and Gottron rash will be further followed. More cases of CADM have been identified in other studies as clinicians have become increasingly aware of the condition 4 . It would be interesting and extremely valuable to be able to predict the onset of ILD and malignancy by distinctive rash.…”

Amyopathic dermatomyositis associated with an endometrial adenocarcinoma

“…However, in contrast to lung cancer, which is the most frequent malignancy associated with classic DM, breast cancer was the most common type of malignancy reported in patients with amyopathic DM [5]. Features such as photosensitivity and periungueal erythema seem to predict the lowest probability of an associated malignancy in amyopathic DM patients [6].…”