Dermatomyositis: Current concepts

Bogdanov, Ivan; Kazandjieva, Jana; Darlenski, Razvigor; Tsankov, Nikolaï

doi:10.1016/j.clindermatol.2018.04.003

Cited by 66 publications

(83 citation statements)

References 64 publications

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“…It can occur spontaneously or in association with neoplastic disorders, presenting as paraneoplastic dermatomyositis. Occasionally, it may also occur secondary to certain drugs, including lipid-lowering agents, penicillamine, hydroxynurea and, rarely, checkpoint inhibitors used in immunotherapy [2,3]. The patient in our case has metastatic melanoma.…”

Section: Discussionmentioning

confidence: 78%

Toripalimab-Induced Dermatomyositis in a Patient with Metastatic Melanoma

Lin

Xue

Gao

et al. 2020

Dermatol Ther (Heidelb)

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Toripalimab is a monoclonal antibody targeting programmed cell death protein 1 (PD-1). It has recently been approved as an immune checkpoint inhibitor in second-line therapies in patients with unresectable or metastatic melanoma; however, it may be associated with various immune-related adverse events (irAEs). Here we report a case of toripalimab-induced dermatomyositis in a patient receiving treatment for metastatic melanoma. The symptoms were relieved by discontinuing toripalimab and administering once-daily intravenous methylprednisolone 1 mg/kg. We suggest that this case serves a warning to clinicians of the need to be aware of the possiblilty of toripalimab-induced dermatomyositis. Early recognition and treatment may prevent progression and improve prognosis of this irAE.

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Section: Discussionmentioning

confidence: 78%

Toripalimab-Induced Dermatomyositis in a Patient with Metastatic Melanoma

Lin

Xue

Gao

et al. 2020

Dermatol Ther (Heidelb)

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“…The association between malignancy and dermatomyositis has been extensively reported. 11 , 12 , 13 Treatment for dermatomyositis includes immunosuppression, usually beginning with prednisone at a daily dose of 1–1.5 mg/kg, followed by steroid-sparing therapies such as methotrexate or azathioprine, and intravenous immunoglobulin for refractory or severe cases. 13 …”

Section: Discussionmentioning

confidence: 99%

Papillitis with retinal venous congestion and intraocular inflammation

Dunn

Sergott

2020

American Journal of Ophthalmology Case Reports

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Purpose To describe a case of pronounced papillitis with diminished venous outflow and vitreous inflammation in a 50-year-old man who was later found to have clinical and serological manifestations of dermatomyositis. Observations A 50-year-old man presented with papillitis associated with venous congestion and intraocular inflammation. He was normotensive, not on medications, and without known heritable hypercoagulable or inflammatory disease. Review of systems revealed axial and proximal muscle pain involving the lower back, hip, and thigh, and he developed a transient rash of the scalp. His evaluation including infectious, hypercoagulable, and inflammatory etiologies was negative except for a significantly elevated Mi-2 antibody titer. Treatment with intravenous and oral steroids improved the papillitis, visual acuity and visual field deficit. Conclusions Significant papillitis and retinal venous stasis with intraocular inflammation may be associated with dermatomyositis. Importance Rapidly progressive optic disc edema with associated inflammation and venous stasis requires a broad work up for infectious, hypercoagulable, and autoimmune etiologies for targeted therapy and visual preservation. To the best of our knowledge, this may be the first reported clinical presentation of dermatomyositis manifesting initially with papillitis and retinal venous congestion, based upon elevated Mi-2 antibodies and additional clinical features.

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“…Variations in several genes have been identified, which may increase a person's risk of developing IIM [5]. Exposure to certain environmental factors may then trigger the disorder: UV light, drugs, infections or an unhealthy lifestyle [6]. In addition, in recent years there has been a growing interest in the paraneoplastic forms of IIM, which are quite frequent [6].…”

Section: Introductionmentioning

confidence: 99%

Supervised Physical Therapy and Polymyositis/Dermatomyositis—A Systematic Review of the Literature

Corrado

Ciardi

Lucignano

2020

Neurology International

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Objective: to find the most up-to-date evidence of the effectiveness and safety of supervised physical therapy in polymyositis/dermatomyositis patients. Methods: a systematic review of the literature in the main scientific databases was carried out. We searched for randomized controlled trials concerning supervised physical therapy and polymyositis/dermatomyositis. The PICOS method was used for the formulation of the clinical query. Methodological quality and the level of evidence of the included studies were assessed using the modified Jadad scale and the Oxford Centre for Evidence-Based Medicine Levels of Evidence guide, respectively. Results: a total of 2591 articles were found. By applying the inclusion/exclusion criteria, six randomized controlled clinical trials were admitted to the final phase of the review. The compared approaches concerned supervised exercise programs based on strategies of muscle strengthening or aerobic work. Following these exercises, an increase in the maximum rate of oxygen consumption, a decrease in creatine phosphokinase levels, an enhancement in the patient’s aerobic performance and an improvement in the quality of life indexes were registered. The methodological quality of the included studies ranged from 3 to 4.5. All the studies were classified as presenting an evidence level of 2b. Conclusions: supervised physical therapy in polymyositis/dermatomyositis is an effective, safe and free-of-contraindications tool to be used both in the acute and in the established phases of the pathology. However, further and higher-quality studies are necessary to confirm those findings, to clarify the timing of exercise delivery and to guide the choice towards different types of muscle contraction exercises.

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Dermatomyositis: Current concepts

Cited by 66 publications

References 64 publications

Toripalimab-Induced Dermatomyositis in a Patient with Metastatic Melanoma

Toripalimab-Induced Dermatomyositis in a Patient with Metastatic Melanoma

Papillitis with retinal venous congestion and intraocular inflammation

Supervised Physical Therapy and Polymyositis/Dermatomyositis—A Systematic Review of the Literature

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