Dermatomyositis with a pityriasis rubra pilaris-like eruption: a little-known distinctive cutaneous manifestation of dermatomyositis

Requena, Luis; Grilli, R.; Soriano, Luisa; Escalonilla, P; Fariña, Carmen; Martín, Luis Ángel Guerras

doi:10.1046/j.1365-2133.1997.6721620.x

Cited by 25 publications

(15 citation statements)

References 17 publications

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“…U wszystkich opisanych dotychczas pacjentów z tą rzadką odmianą DM wykwity skórne zlokalizowane były okołomieszkowo. Obraz histopatologiczny bioptatu ze zmian skórnych u pacjentów z postacią Wonga może odpowiadać zarówno DM, jak i łupie-żowi czerwonemu mieszkowemu [9,10].…”

Section: Zmiany Skórneunclassified

Special papers Diagnostic and therapeutic advances in dermatomyositis

Samotij¹,

Szczęch²,

Reich³

2015

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StreSzczenieZapalenie skórno-mięśniowe (dermatomyositis -DM) zalicza się do grupy tzw. idiopatycznych miopatii zapalnych (ang. idiopathic inflammatory myopathies -IIM). Schorzenie to ma podłoże autoimmunologiczne, cechuje się obecnością zmian skórnych i/lub objawami zapalenia mięśni. Wyróżnia się tzw. klasyczną postać DM, postać dziecięcą DM oraz paraneoplastyczną DM, DM indukowane lekami i DM bez zaję-cia mięśni. Ostatnio obserwuje się dynamiczny postęp w identyfikacji nowych autoprzeciwciał towarzyszących poszczególnym odmianom DM, w tym anty-TIF1, anty-NXP2, anty-SAE czy anty-MDA5. Prawdopodobnie w niedalekiej przyszłości przyczyni się on do zwiększenia częstości rozpoznawania DM i jego poszczególnych odmian, lepszej stratyfikacji pacjentów pod względem ryzyka zajęcia poszczególnych narządów wewnętrznych oraz wpłynie na całościową poprawę wyników leczenia. Obecnie glikokortykosteroidy są podstawą terapii DM, jednak wprowadzenie do lecznictwa szeregu nowych leków immunomodulujących i immunosupresyjnych, w tym leków biologicznych, wiąże się ze znaczącym zwiększeniem przeżywalności pacjentów z tą chorobą. W niniejszej pracy dokonano przeglądu piśmiennictwa na temat najnowszych trendów w diagnostyce i leczeniu DM. AbStrActDermatomyositis (DM) is one of the so-called idiopathic inflammatory myopathies (IIM). Dermatomyositis is an autoimmune disorder characterized by the presence of cutaneous lesions and/or symptoms of muscle involvement with the following variants: the "classic" variant of DM, juvenile DM, paraneoplastic DM, drug-induced DM and amyopathic DM. Dynamic discoveries of novel autoantibodies, including anti-TIF1, anti-NXP2, anti-SAE or anti-MDA5, related to certain DM variants, have been described in recent years. It seems that these antibodies will contribute to better recognition of DM and its particular variants, a better risk stratification for predicting internal organ involvement, and to a global improvement of treatment outcome. Corticosteroids remain the mainstay of DM therapy, but new immunomodulatory and immunosuppressive agents, including biologicals, resulted in a significant increase of the survival rate of DM patients. Here, we review the current literature data on DM with special emphasis on new trends in its diagnostics and treatment.

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Section: Zmiany Skórneunclassified

Special papers Diagnostic and therapeutic advances in dermatomyositis

Samotij¹,

Szczęch²,

Reich³

2015

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“…Dermatomyositis with PRP is known as type Wong variant dermatomyositis, named after Wong who described a large series of patients from Hong Kong in 1969 (Requena et al, 1997;Lupton et al, 2000). However, it was believed that that PRP as a manifestation of dermatomyositis may have been reported as early as 1953 by O'Leary who did not describe or illustrate the histopathological findings (Requena et al, 1997;Lupton et al, 2000).…”

Section: Rheumatologic Associationsmentioning

confidence: 99%

“…However, it was believed that that PRP as a manifestation of dermatomyositis may have been reported as early as 1953 by O'Leary who did not describe or illustrate the histopathological findings (Requena et al, 1997;Lupton et al, 2000).…”

Section: Rheumatologic Associationsmentioning

confidence: 99%

A Review of Pityriasis Rubra Pilaris and Rheumatologic Associations

Chan

Liu

Naguwa

2004

Journal of Immunology Research

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Pityriasis rubra pilaris (PRP) is a rare group of hyperkeratotic, papulosquamous disease that can be acquired or inherited. There have been reported cases of rheumatologic associations, mainly arthritis and dermatomyositis. In this review article, we will explore the clinical presentation and classification, rheumatologic associations and treatment modalities of PRP. In addition, we will also report a case of PRP with seronegative arthritis.Keywords: Pityriasis rubra pilaris; Review; Arthritis; Rheumatologic; Treatment CASE REPORTA 50-year-old East Indian male with a 2-year history of nonspecific knee arthritis presented to his primary care doctor with a new scaly and pruritic rash. It began on the extensor surfaces of the elbow and bilaterally spread onto the forearms. Similar lesions began to appear over the scalp, trunk, axilla and knee. His nails became thickened and hyperpigmented. The patient was diagnosed with psoriasis. With the appearance of the lesions, his knee pain intensified, especially when ascending the stairs. The pain would awaken him at night. During this period, he had stiffening of his extremities. Besides fatigue, he denied any recent acute illnesses, constitutional symptoms, and mucocutaneous or ocular lesions. His past medical history included hypothyroidism and seasonal allergies. He denied food, drug and environmental allergies. His medication list at presentation included levothyroxine and glucosamine and chondroitin. He smoked tobacco occasionally and owned a cat. He had not traveled outside the country recently. His mother had nonspecific arthritis. On physical examination, his vitals were normal. There were no lymphadenopathy, oral lesions and hepatosplenomegaly. Neither joint deformity nor synovitis was appreciated. He had tenderness of the right knee on palpation with mild patellar laxity. He had multiple sharply demarcated redorange scaly plaques over the extensor surfaces of the forearms, axillae, knees and trunk. The plaques were nearly confluent on his trunk with the exception of islands of normal skin. The skin of his palms was thick and dry. Bilaterally, his second and third fingernails were hyperkeratotic with pitting and hyperpigmentation.X-rays of the hands and knees were normal. Complete blood count, complete metabolic panel and urinalysis were normal. The erythrocyte sedimentary rate was 15; antinuclear antibody was 1:160 with a nucleolar pattern. Thyroid stimulating hormone, immunoglobulin and complement levels were normal. Rheumatoid factor, hepatitis panel and RPR were negative. He did not respond to the conventional psoriatic treatment with ultraviolet light therapy UVA and UVB. Eventually, a punch biopsy was performed, and a diagnosis of pityriasis rubra pilaris (PRP) was made. The patient was placed on methotrexate therapy and his arthritis and skin lesions subsequently resolved.

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“…[1][2][3][4][5][6][7][8][9][10][11][12] Usually, these patients exhibit classical cutaneous lesions of dermatomyositis and stereotypical lesions of pityriasis rubra pilaris. [1][2][3][4][5][6][7][8][9][10][11][12] Usually, these patients exhibit classical cutaneous lesions of dermatomyositis and stereotypical lesions of pityriasis rubra pilaris.…”

Section: Introductionmentioning

confidence: 99%