Number, characteristics, and classification of patients with dermatomyositis seen by dermatology and rheumatology departments at a large tertiary medical center

Klein, Rhonda Q.; Teal, Valerie; Taylor, Lynne; Troxel, Andrea B.; Werth, Victoria P.

doi:10.1016/j.jaad.2007.08.024

Cited by 55 publications

(36 citation statements)

References 20 publications

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“…The most common clinical presentation was muscular weakness with predominance of proximal myopathy in (93.9%) followed by arthralgia/arthritis (82.1%), both with a higher prevalence than other studies [14,19]. Several nonmuscular manifestations have been wildly described, and dysphagia is the most common among all [6,7,23,25,26], it is noted that we have lower prevalence of dysphagia (35.70%) than other studies [14,27] which could be contributed to early diagnosis and intervention.…”

Section: Discussionmentioning

confidence: 51%

Inflammatory Muscle Disease, 15-Year Experience at Tertiary Centers

Attar¹,

Babaeer²,

Bagais³

et al. 2016

Intern Med

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Objectives: Idiopathic inflammatory myopathies (IIM) are a group of inflammatory muscle diseases with a paucity of data and literature from Saudi Arabia. The aim was to describe the demographics, evaluate clinical features, organ involvement, investigations, treatment strategies, and to assess factors affecting remission in IIM patients. Methods:We conducted this retrospective study at 5 medical tertiary centers in Saudi Arabia to analyze the records of patients with IIM from 1999 to 2014.Results: A total of 28 patients with IIM were identified with a female to male ratio of 3:1. Pure polymyositis accounted for (32.1%), pure dermatomyositis (21.4%), juvenile dermatomyositis (10.7%), and IIM mixed with connective tissue diseases (35.7%) of the patients. The most common presentation was proximal myopathy (93.9%). The musculoskeletal system was the most commonly involved (78.6%), followed by the gastrointestinal system (39.3%). Investigations revealed an elevated CK of 2995.12 ± 3431.51 (mean ± SD), EMG was positive in (92.9%) of patient, and muscle biopsy in (42.9%). Treatment data showed a good response to Prednisolone (96.4%). Conclusion:The results of this multiregional retrospective study from Saudi Arabia on IIM patients showed similar clinical features to other reviews; however, malignancy percentages were lower. We found a strong relation between comorbid illnesses and relapse. Normalization of muscle power is a reliable prognostic factor that may help assess the efficacy of treatment.

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Section: Discussionmentioning

confidence: 51%

Inflammatory Muscle Disease, 15-Year Experience at Tertiary Centers

Attar¹,

Babaeer²,

Bagais³

et al. 2016

Intern Med

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“…21,22 Of the immunosuppressive agents, the following are second-line treatment: azathioprine; cyclosporine; cyclophosphamide; and methotrexate. 22 There are no protocols defi ning the best treatment for DM.…”

Section: Discussionmentioning

confidence: 99%

Dermatomiosite em adulto: experiência de um centro terciário brasileiro

Souza¹,

Barros²,

Levy‐Neto³

et al. 2012

Rev. Bras. Reumatol.

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Objective: To report the results of a retrospective cohort involving 139 patients with dermatomyositis, conducted from 1991 to 2011. Methods: All patients met at least four of the fi ve Bohan and Peter criteria (1975). Results: The patients' mean age at disease onset was 41.7 ± 14.1 years, and mean disease duration was 7.2 ± 5.2 years. The sample comprised 90.2% white patients and 79.9% female patients. Constitutional symptoms occurred in less than half of the patients. Cutaneous and joint involvements occurred in 95.7% and 41.7% of the patients, respectively. Incipient pneumopathy, ground glass opacities and/or pulmonary fi brosis were present in 48.2% of the patients. All patients received prednisone (1 mg/kg/day) and 51.1% also received intravenous methylprednisolone (1 g/day for three days). Several immunosuppressants were used as corticosteroid sparing agents according to tolerance, side effects and/or refractoriness. Although disease relapse (clinical and/or laboratory) occurred in 53.2% of the patients, 76.3% were in disease remission at the end of the study. The rate of severe infection was 35.3%, and herpes zoster predominated. There were 15 (10.8%) cases of cancer, 12 within one year after the diagnosis. There were 16 deaths (11.5%), and their major causes were sepsis/septic shock (27.5%), pneumopathy attributed to the disease (31.3%), neoplasms (31.3%), and cardiovascular events (12.5%). Conclusions: In this study, the clinical and laboratory data were similar to those of other population groups described in the literature, with minimal differences regarding the frequency and characteristics of the extramuscular manifestations.

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“…Accompanying muscle disease requires treatment with high-dose corticosteroids. Patients with dermatomyositis and amyopathic dermatomyositis are also at increased risk of interstitial lung disease and should be routinely screened for this complication with pulmonary function tests and diffusion capacity [29,30,31,32,33]. Ultraviolet light plays a role in the pathogenesis of dermatomyositis, and patients should be counseled on ultraviolet light minimization techniques [34].…”

Section: Discussionmentioning

confidence: 99%

Multicentric Reticulohistiocytosis with Dermatomyositis-Like Features: A More Common Disease Presentation than Previously Thought

Fett

Liu

2011

Dermatology

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Multicentric reticulohistiocytosis (MRH) is a rare form of non-Langerhans histiocytosis that presents with erosive arthritis and skin nodules. Approximately 25% of patients with MRH have an associated malignancy. Dermatomyositis is an inflammatory autoimmune condition that has also been associated with malignancy. To date, 7 cases of MRH have been reported to present with cutaneous features of dermatomyositis. We describe an eighth patient with MRH who presented with dermatomyositis-like features (V-neck erythema, shawl sign, Gottron’s papules and periungual erythema), who developed metastatic breast cancer 1 year after diagnosis. We hypothesized that clinical overlap between MRH and dermatomyositis was not as uncommon as review of the literature suggested. Careful review of the physical exam findings and photographs of the 234 papers reporting MRH revealed 27 cases of MRH with dermatomyositis-like features. Of these 27 cases, 7 (26%) were associated with a malignancy. Skin biopsies of the cutaneous features mimicking dermatomyositis revealed pathologic features of MRH. This is a descriptive analysis of published case reports. Based on a review of published case reports, MRH presenting with dermatomyositis-like features is likely fairly common. Histological examination of skin biopsies allows for disease differentiation. Differentiating MRH from dermatomyositis is important for management decisions and comorbidity screening.

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Number, characteristics, and classification of patients with dermatomyositis seen by dermatology and rheumatology departments at a large tertiary medical center

Cited by 55 publications

References 20 publications

Inflammatory Muscle Disease, 15-Year Experience at Tertiary Centers

Inflammatory Muscle Disease, 15-Year Experience at Tertiary Centers

Dermatomiosite em adulto: experiência de um centro terciário brasileiro

Multicentric Reticulohistiocytosis with Dermatomyositis-Like Features: A More Common Disease Presentation than Previously Thought

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