Gottrons's papule in amyopathic dermatomyositis mimicking psoriasis

Haroon, Muhammad; Devlin, Joe

doi:10.1007/s10067-009-1244-6

Cited by 12 publications

(8 citation statements)

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“…Interestingly, some patients with amyopathic dermatomyositis without clinical myositis still have abnormal findings on ultrasound, magnetic resonance imaging, or muscle biopsy [11,12]. In agreement with previous authors, we believe that overly strict interpretation of diagnostic criteria may lead to underdiagnosis and undertreament of amyopathic dermatomyositis in some patients who are not evaluated beyond clinical, immunological and enzymatic studies [11-14].…”

Section: Discussionsupporting

confidence: 82%

“…Euwer et al first conceptualized that it may represent one continuum of disease spectrum with dermatomyositis-polymyositis on the other [11]. A failure to recognize amyopathic dermatomyositis early in the absence of myositis may cause considerable delays in diagnosis, which is relevant because amyopathic dermatomyositis may still be associated with life threatening systemic diseases including interstitial pulmonary fibrosis [12-14]. Our patient's presentation with sequential amyopathic dermatomyositis and severe pulmonary interstitial fibrosis is strengthened by the positive anti-JO1 antibody testing [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Prognosis of dermatomyositis is related to severity of myopathy, related end organ damage, and coexistent malignancy [11,12]. Interstitial pulmonary fibrosis is perhaps the most pertinent and potentially life-threatening complication associated with amyopathic dermatomyosisits and yet its clinical features are not well understood [13,14] (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

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Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report

Nguyen

2010

J Med Case Reports

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IntroductionDermatomyositis has been described in the setting of lyme infection in only nine previous case reports. Although lyme disease is known to induce typical clinical findings that are observed in various collagen vascular diseases, to our knowledge, we believe that our case is the first presentation of acute lyme disease associated with amyopathic dermatomyositis, which was then followed by severe and fatal interstitial pulmonary fibrosis only two months later.Case presentationWe present a case of a 64-year-old African-American man with multiple medical problems who was diagnosed with acute lyme infection after presenting with the pathognomonic rash and confirmatory serology. In spite of appropriate antimicrobial therapy for lyme infection, he developed unexpected amyopathic dermatomyositis and then interstitial lung disease.ConclusionsThis case illustrates a potential for lyme disease to produce clinical syndromes that may be indistinguishable from primary connective tissue diseases. An atypical and sequential presentation (dermatomyositis and interstitial lung disease) of a common disease (lyme infection) is discussed. This case illustrates that in patients who are diagnosed with lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary complications should be considered.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report

Nguyen

2010

J Med Case Reports

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“…Conversely, the skinderived T cells contained a substantial number of IL-17A-producing Th17 cells in some of the DM patients, which are well known as pathogenic T cells for psoriasis [12,13]. Clinically, DM shares hyperkeratotic erythema with psoriasis [14]. Th17-producing cytokines, IL-17A and IL-22, may also contribute to the skin lesions of DM.…”

Section: Discussionmentioning

confidence: 99%

Preferential infiltration of interleukin-4-producing CXCR4+ T cells in the lesional muscle but not skin of patients with dermatomyositis

Fujiyama

Ito

Ogawa

et al. 2014

Clinical and Experimental Immunology

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SummaryDermatomyositis (DM) and polymyositis (PM) are collectively termed autoimmune myopathy. To investigate the difference between muscle-and skininfiltrating T cells and to address their role for myopathy, we characterized T cells that were directly expanded from the tissues. Enrolled into this study were 25 patients with DM and three patients with PM. Muscle and skin biopsied specimens were immersed in cRPMI medium supplemented with interleukin ( Our study suggests that T cell populations in the muscle and skin are different, and the Th2 cell infiltrate in the muscle is associated with the low severity of myositis in DM.

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“…Спочатку це було зумовлено чисто діагностичною проблемою: поява на третьому році від початку хвороби численних бляшкопо дібних сріблястих лускатих висипань, локалі зованих на волосистій частині голови, тулубі та кінцівках, які супроводжувалися незначним свербежем, спричинила низку запитань стосов но їхньої оцінки. Річ в тому, що на той час вже було відомо про можливості паралельного перебігу ЮДМ/ЮДМам/ДМ та псоріазу або виникнення при цих захворюваннях псоріазоподібного висипу [6,12,16,30,36] Читайте нас на сайті: http://med expert.com.ua більш пізні наукові повідомлення про подібні випадки [11,23,26,45] наголошують на серйоз ній проблемі швидкої верифікації діагнозу та неминучій потребі міждисциплінарного під ходу у спробі її вирішення. Аналогічна ситуація склалася при диференціації висипу і в нашого хворого: лише тісна співпраця дитячих кардіо ревматологів, дерматологів, імунологів та мор фологів дозволила констатувати у нього співіс нування двох захворювань.…”

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Debut and course rare of juvenile dermatomyositis. Part II: clinical analysis with comparative analytical review of the literature

Rеitmаier¹,

Volosyanko²,

Synoverska³

et al. 2020

MPU

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The first part of the article describes a rare case of the onset and course of juvenile dermatomyositis. In the second part the comparative clinical analysis of results of own supervision with other similar reports is carried out. The main attention is focused on atypical variants of the onset of the disease, in particular signs of severe intoxication syndrome, hemorrhagic-necrotic rash, anasarca, lesions of the oral cavity in the form of stomatitis and ulcerative-necrotic glossitis. The difficulties of early diagnosis of the disease on the background of delayed manifestation of pathognomonic skin signs and the absence of reliable features of myopathic syndrome are shown. Clinical and laboratory characteristics of amyopathic juvenile dermatomyositis with persistent skin lesions have been defined. There are three differentiated plans-recommendations of the Childhood Arthritis and Rheumatology Research Alliance for the treatment of patients who have never had muscle damage and those who have had clinical manifestations of myopathy only in the first months of the disease. Current trends in achievements and gaps in the classification, diagnosis and treatment of various forms of juvenile dermatomyositis have been observed. On the basis of scientific publications the possible prognostic consequences of the amyopathic form of this disease in children are highlighted. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: juvenile dermatomyositis, juvenile amyopathic dermatomyositis, atypical course, ulcerative necrotic glossitis, anasarca, psoriasis, treatment.

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Gottrons's papule in amyopathic dermatomyositis mimicking psoriasis

Cited by 12 publications

References 1 publication

Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report

Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report

Preferential infiltration of interleukin-4-producing CXCR4+ T cells in the lesional muscle but not skin of patients with dermatomyositis

Debut and course rare of juvenile dermatomyositis. Part II: clinical analysis with comparative analytical review of the literature

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