Journal Information
Vol. 5. Issue 5.
Pages 216-222 (September - October 2009)
Share
Share
Download PDF
More article options
Vol. 5. Issue 5.
Pages 216-222 (September - October 2009)
Full text access
Dermatomyositis
Dermatomiosistis
Visits
11219
Isabel Bielsa Marsol
Corresponding author
ibielsa.germanstrias@gencat.cat

Corresponding author.
Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain
This item has received
Article information
Abstract

Dermatomyositis is a form of idiopathic inflammatory myopathy that involves skeletal muscle and skin. The objectives of this review are to briefly describe the cutaneous manifestations of the disease, to raise some questions still debated about amyopathic dermatomyositis, and to reflect current knowledge of an interesting aspect in dermatomyositis as it is the risk to develop malignancy. Although clear evidence for a significant dermatomyositis-cancer association exists, optimal clinical or biological factors that predict an association with cancer have not been identified. Recently, some specific autoantibodies in dermatomyositis have been shown to be associated with internal malignancy. They open up the possibility to have available serological markers for detecting cancer-associated myositis in the near future.

Keywords:
Cutaneous lesions
Amyopathic dermatomyositis
Malignancy-associated myositis
Myositis-specific autoantibodies
Resumen

La dermatomiositis es un tipo de miopatía inflamatoria idiopática que afecta al músculo esquelético y a la piel. Los objetivos de esta revisión son, en primer lugar, dar una pincelada breve sobre las manifestaciones cutáneas de la enfermedad para los que no estén tan familiarizados con éstas; en segundo lugar, plantear algunas cuestiones aún debatidas sobre la dermatomiositis amiopática, y, en tercer lugar, revisar un aspecto muy interesante como es el de la dermatomiositis y el riesgo de desarrollo de neoplasia. Respecto a este último punto, está claro que los pacientes con dermatomiositis tienen un mayor riesgo de desarrollo de una neoplasia y si bien no hay marcadores clínicos o biológicos claros de la presencia de ésta, es posible que en un futuro próximo se pueda disponer de autoanticuerpos que puedan desempeñar este importante papel.

Palabras clave:
Lesiones cutáneas
Dermatomiositis amiopática
Neoplasia asociada a miositis
Anticuerpos específicos de miositis
Full text is only aviable in PDF
References
[1.]
M.C. Dalakas.
Polymiosits, dermatomyositis and inclusion-body myositis.
N Engl J Med, 325 (1991), pp. 1487-1498
[2.]
F.W. Miller.
Classification and prognosis of inflammatory muscle disease.
Rheum Dis Clin North Am, 20 (1994), pp. 811-826
[3.]
A. Bohan, J.B. Peter.
Polymyositis and dermatomyositis: Parts 1 and 2.
N Engl J Med, 292 (1975), pp. 344-347
[4.]
L.A. Love, R.L. Leff, D.D. Fraser, I.N. Targoff, M. Dalakas, P.H. Plotz, et al.
A new approach to the classification of idiopathic inflammatory myopathy: Myositis-specific autoantibodies define useful homogeneous patient groups.
Medicine (Baltimore), 70 (1991), pp. 360-374
[5.]
T. Mimori, Y. Imura, R. Nakashima, H. Yoshifugi.
Autoantibodies in idiopathic inflammatory myopathy: An update on clinical and pathophysiological significance.
Curr Opin Rheumatol, 19 (2007), pp. 523-529
[6.]
H. Yoshifuji, T. Fujii, S. Kobayashi, Y. Imura, Y. Fujita, D. Kawabata, et al.
Anti-aminoacylt-RNA synthetase antibodies in clinical course prediction of interstitial lung disease complicated with idiopathic inflammatory myopathies.
Autoimmunity, 39 (2006), pp. 233-241
[7.]
I.N. Targoff, M. Reichlin.
The association between Mi-2 antibodies and dermatomyositis.
Arthritis Rheum, 28 (1985), pp. 796-803
[8.]
H.P. Seelig, I. Moosbrugger, H. Ehrfeld, T. Fink, M. Renz, E. Genth.
The major dermatomyositis-specific Mi-2 autoantigen is a presumed helicase involved in transcriptional activation.
Arthritis Rheum, 38 (1995), pp. 1389-1399
[9.]
Q. Ge, D.S. Nilasena, C.A. O’Brien, M.B. Frank, I.N. Targoff.
Molecular analysis of a major antigenic region of the 240-kD protein of Mi-autoantigen.
J Clin Invest, 96 (1995), pp. 1730-1737
[10.]
H.P. Seelig, M. Renz, I.N. Targoff, Q. Ge, M.B. Frank.
Two forms of the major antigenic protein of the dermatomyositis-specific Mi-2 autoantigen.
Arthritis Rheum, 39 (1996), pp. 1769-1771
[11.]
G.J. Hengstman, W.T. Vree Egberts, H.P. Seelig, I.E. Lundberg, H.M. Moutsopoulos, A. Doria, et al.
Clinical characteristics of patients with myositis and auto-antibodies to different fragments of the Mi-2 beta antigen.
Ann Rheum Dis, 65 (2006), pp. 242-245
[12.]
I.N. Targoff, A.E. Johnson, F.W. Miller.
Antibody to signal recognition particle in polymyositis.
Arthritis Rheum, 33 (1990), pp. 1361-1370
[13.]
M. Hirakata, T. Mimori, M. Akizuki, J. Craft, J.A. Hardin, M. Homma.
Autoantibodies to small nuclear and cytoplasmic ribonucleoproteins in Japanese patients with inflammatory muscle disease.
Arthritis Rheum, 35 (1992), pp. 449-456
[14.]
G.J. Hengstman, H.J. Ter Laak, W.T. Vree Egberts, I.E. Lundberg, H.M. Moutsopoulos, J. Vencovsky, et al.
Anti-signal recognition particle autoantibodies: Marker of a necrotising myopathy.
Ann Rheum Dis, 65 (2006), pp. 1635-1638
[15.]
J.B. Arlet, D. Dimitri, C. Pagnoux, O. Boyer, T. Maisonobe, F.J. Authier, et al.
Marked efficacy of a therapeutic strategy associating prednisone and plasma exchange followed by rituximab in two patients with refractory myopathy associated with antibodies to the signal recognition particle (SRP).
Neuromuscul Disord, 16 (2006), pp. 334-336
[16.]
R.L. Euwer, R.D. Sontheimer.
Dermatologic aspects of myositis.
Curr Opin Rheumatol, 6 (1994), pp. 583-589
[17.]
R.D. Sontheimer.
Cutaneous features of classic dermatomyositis and amyopathic dermatomyositis.
Curr Opin Rheumatol, 11 (1999), pp. 475-482
[18.]
S.O. Kovacs, S.C. Kovacs.
Dermatomyositis.
J Am Acad Dermatol, 39 (1998), pp. 899-920
[19.]
J.P. Callen.
Dermatomyositis.
[20.]
Y. Scrivener, El Aboubi-Kühne, C. Marquart-Elbaz, B. Cribier.
Diagnostic d’un oedème orbito-palpébral.
Ann Dermatol Venereol, 126 (1999), pp. 844-848
[21.]
L.M. Pachman.
Juvenil dermatomyositis. Pathophysiology and disease expression.
Pediatr Clin North Am, 42 (1995), pp. 1071-1098
[22.]
M.L. McCollough, C.J. Cockerell.
Vesiculo-bullous dermatomyositis.
Am J Dermatopath, 20 (1998), pp. 170-174
[23.]
K. Molnar, L. Kemeny, I. Korom, A. Dobozy.
Panniculitis in dermatomyositis: Report of two cases (letter).
Br J Dermatol, 139 (1998), pp. 161-163
[24.]
H.C. Nousari, V.T. Ha, S.D. Laman, T.T. Provost, F.A. Tausk.
“Centripetal flagellate erythema”: A cutaneous manifestation associated with dermatomyositis.
J Rheumatol, 26 (1999), pp. 692-695
[25.]
A. Kimyai-Asadi, F.A. Tausk, H.C. Nousari.
A patient with dermatomyositis and linear streaks on the back.
Arch Dermatol, 136 (2000), pp. 665-670
[26.]
J. del Pozo, M. Almagro, W. Martínez, M.T. Yebra-Pimentel, J. García Silva, C. Peña-Penabad, et al.
Dermatomyositis and mucinosis.
Int J Dermatol, 40 (2001), pp. 120-124
[27.]
E. Tan, S.H. Tan, S. Ket.
Cutaneous mucinosis in dermatomyositis associated with a malignant tumor.
J Am Acad Dermatol, 48 (2003), pp. S41-S42
[28.]
N.L. Stahl, J.H. Klippel, J.L. Decker.
A cutaneous lesion associated with myositis.
Ann Intern Med, 91 (1979), pp. 577-579
[29.]
D. Mitra, C.L. Lovell, T.I.F. Macleod, R.S.H. Tan, P.J. Maddison.
Clinical and histological features of “mechanic's hands” in a patient with antibodies to Jo-1. A case report.
Clin Exp Dermatol, 19 (1994), pp. 146-148
[30.]
F. Indart, A. España, M.A. Idoate, I. Lucas, E. Quintanilla.
A cutaneous lesion associated with primary polymyositis.
Arch Dermatol, 129 (1993), pp. 1207-1208
[31.]
V. García-Patos, R. Bartralot, V. Fonollosa, C. Arnal, M. Boronat, C. Gelpí, et al.
Childhood sclerodermatomyositis: Report of a case with the anti-PM/Scl antibody and mechanic's hands.
Br J Dermatol, 135 (1996), pp. 613-616
[32.]
P. Gerami, J.M. Schope, L. McDonald, H.W. Walling, R.D. Sontheimer.
A systematic review of adult-onset clinically amyopathic dermatomyositis (dermatomyositis siné myositis): A missing link within the spectrum of the idiopathic inflammatory myopathies.
J Am Acad Dermatol, 54 (2006), pp. 597-613
[33.]
R.D. Sontheimer.
Cutaneous features of classic dermatomyositis and amyopathic dermatomyositis.
Curr Opin Rheumatol, 11 (1999), pp. 475-482
[34.]
R.L. Euwer, R.D. Sontheimer.
Amyopathic dermatomyositis: A review.
J Invest Dermatl, 100 (1993), pp. 124S-S127
[35.]
J.L. Jorizzo.
Dermatomyositis. Practical aspects.
Arch Dermatol, 138 (2002), pp. 114-116
[36.]
M.R. Stonecipher, J.L. Jorizzo, J. Monu, F. Walker, P.G. Sutej.
Dermatomyositis with normal muscle enzyme concentrations. A single-blind study of the diagnostic value of magnetic resonance imaging and ultrasound.
Arch Dermatol, 130 (1994), pp. 1294-1299
[37.]
A. Cosnes, F. Amaudric, R. Gherardi, J. Verroust, J. Wechsler, J. Revuz, et al.
Dermatomyositis without muscle weakness Long term follow-up of 12 patients without systemic corticosteroids.
Arch Dermatol, 131 (1995), pp. 1381-1385
[38.]
S. Sato, M. Hirakata, M. Kuwana, A. Suwa, S. Inada, T. Mimori, et al.
Autoantibodies to a 140-kd polypeptide CADM-140, in Japanese patients with clinically amyopathic dermatomyositis.
Arthritis Rheum, 52 (2005), pp. 1571-1576
[39.]
R.L. Euwer, R.D. Sontheimer.
Amyopathic dermatomyositis (dermatomyositis sine myositis). Presentation of six new cases and review of literature.
J Am Acad Dermatol, 24 (1991), pp. 959-966
[40.]
R.A. El-Azhary, S.Y. Pakzad.
Amyopathic dermatomyositis: Retrospective review of 37 cases.
J Am Acad Dermatol, 46 (2002), pp. 560-565
[41.]
M. Caproni, C. Cardinali, A. Parodi, B. Giomi, M. Papini, M. Vaccaro, et al.
Amyopathic dermatomyositis: A review by the Italian group of immunodermatology.
Arch Dermatol, 138 (2002), pp. 23-27
[42.]
L.A. Manchul, A. Jin, K.I. Pritchard, J. Tenenbaum, N.F. Boyd, P. Lee, et al.
The frequency of malignant neoplasms in patients with polymyositis-dermatom- yositis. A controlled study.
Arch Intern Med, 145 (1985), pp. 1835-1839
[43.]
S. Lakhanpal, T.W. Bunch, D.M. Ilstrup, L.J. Melton.
Polymyositis-dermatomyositis and malignant lesions: Does an association exist?.
Mayo Clin Proc, 61 (1986), pp. 645-653
[44.]
M.G. Lyon, D.A. Bloch, B. Hollak, J.F. Fries.
Predisposing factors in polymyositisdermatomyositis: Results of a nationwide survey.
J Rheumatol, 16 (1989), pp. 1218-1224
[45.]
B. Sigurgeirsson, FB. Lindelö, O. Edhag, E. Allander.
Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study.
N Engl J Med, 326 (1992), pp. 363-367
[46.]
W.H. Chow, G. Gridley, L. Mellemkjaer, J.K. McLaughlin, J.H. Olsen, J.F. Fraumeni Jr..
Cancer risk following polymyositis and dermatomyositis: A nationwide cohort study in Denmark.
Cancer Causes Control, 6 (1995), pp. 9-13
[47.]
A. Airio, E. Pukkala, H. Isomäki.
Elevated cancer incidence in patients with dermatomyositis: A population based study.
J Rheumatol, 22 (1995), pp. 1300-1303
[48.]
C.R. Maoz, P. Langevitz, A. Livneh, Z. Blumstein, M. Sadeh, I. Bank, et al.
High incidence of malignancies in patients with dermatomyositis and polymyositis: An 11-year analysis.
Semin Arthritis Rheum, 27 (1998), pp. 319-324
[49.]
M. Patrick, R. Buchbinder, D. Jolley, X. Dennett, R. Buchanan.
Incidence of inflammatory myopathies in Victoria, Australia, and evidence of spatial clustering.
J Rheumatol, 26 (1999), pp. 1094-1100
[50.]
R. Buchbinder, A. Forbes, S. Hall, X. Dennett, G. Giles.
Incidence of malignant disease in biopsy-proven inflammatory myopathy. A population-based cohort study.
Ann Intern Med, 134 (2001), pp. 1087-1095
[51.]
C.L. Hill, Y. Zhang, B. Sigurgeirsson, E. Pukkale, L. Mellemkjaer, A. Airio, et al.
Frequency of specific cancer types in dermatomyositis and polymiositis: A population-based study.
[52.]
J. Benbassat, D. Gefel, K. Larholt, S. Sukenik, V. Morgenstern, Zlotnick.
A prognostic factors in polymyositis/dermatomyositis. A computer-assisted analysis of ninetytwo cases.
Arthritis Rheum, 28 (1985), pp. 249-255
[53.]
N.H. Cox, C.M. Lawrence, J.A. Langtry, F.A. Ive.
Dermatomyositis. Disease associations and an evaluation of screening investigations for malignancy.
Arch Dermatol, 12 (1990), pp. 61-65
[54.]
I. Marie, P.Y. Hatron, H. Levesque, E. Hachulla, M.F. Hellot, U. Michon-Pasturel, et al.
Influence of age on characteristics of polymyositis and dermatomyositis in adults.
Medicine (Baltimore), 78 (1999), pp. 139-147
[55.]
E. Pautas, P. Chérin, J.C. Piette, S. Pelletier, B. Wechsler, J. Cabane, et al.
Features of polymyositis and dermatomyositis in the elderly: A case-control study.
Clin Exp Rheumatol, 18 (2000), pp. 241-244
[56.]
Y.J. Chen, C.Y. Wu, J.L. Shen.
Predicting factors of malignancy in dermatomyositis and polymyositis: A case-control study.
Br J Dermatol, 144 (2001), pp. 825-831
[57.]
N. Basset-Seguin, J.C. Roujeau, R. Gherardi, J.C. Guillaume, J. Revuz, R. Touraine.
Prognosis factors and predictive signs of malignancy in adult dermatomyositis.
Arch Dermatol, 126 (1990), pp. 633-637
[58.]
V. Gallais, B. Crickx, S. Belaïch.
Facteurs pronostiques et signes prédictifs de cancer au cours de la dermatomyosite de l’adulte.
Ann Dermatol Venereol, 123 (1996), pp. 722-726
[59.]
M. Burnouf, E. Mahé, P. Verpillat, V. Descamps, B. Lebrun-Vignes, C. Picard-Dahan, et al.
Les necroses cutanées dans les dermatomyosites de l’adulte sont prédictives de l’association àune néoplasie.
Ann Dermatol Venereol, (2003), pp. 313-316
[60.]
J.M. Grau, O. Miró, E. Pedrol, J. Casademont, F. Masané s, C. Herrero, et al.
Interstitial lung disease related to dermatomyositis. Comparative study with patients without lung involvement.
J Rheumatol, 23 (1996), pp. 1921-1926
[61.]
Z. Amoura, P. Duhaut, D.L. Huong, B. Wechsler, N. Costedoat-Chalumeau, C. Francès, et al.
Tumor antigen markers for the detection of solid cancers in inflammatory myopathies.
Cancer Epidemiol Biomarkers Prev, 14 (2005), pp. 1279-1282
[62.]
E.J. Fudman, T.J. Schnitzer.
Dermatomyositis without creatine kinase elevation. A poor prognostic sign.
Am J Med, 80 (1986), pp. 329-332
[63.]
S.E. Whitmore, R. Watson, N.B. Rosenshein, T.T. Provost.
Dermatomyositis sine myositis: Association with malignancy.
J Rheumatol, 23 (1996), pp. 101-105
[64.]
W.K. Fung, H.L. Chan, W.M. Lam.
Amyopathic dermatomyositis in Hong Kong: Association with nasopharyngeal carcinoma.
Int J Dermatol, 37 (1998), pp. 659-663
[65.]
A. Sparsa, E. Liozon, F. Herrmann, K. Ly, V. Lebrun, P. Soria, et al.
Routine vs extensive malignancy search for adult dermatomyositis and polymyositis: A study of 40 patients.
Arch Dermatol, 138 (2002), pp. 885-890
[66.]
G. La Montagna, C. Manzo, E. Califano, R. Tirri.
Absence of elevated creatine kinase in dermatomyositis does not exclude malignancy.
Scand J Rheumatol, 17 (1988), pp. 73-74
[67.]
Y. Troyanov, I.N. Targoff, J.L. Tremblay, J.R. Goulet, Y. Raymond, J.L. Senécal.
Novel classification of idiopathic inflammatory myopathies based on overlap syndrome features and autoantibodies: Analysis of 100 French Canadian patients.
Medicine (Baltimore), 84 (2005), pp. 231-249
[68.]
I.N. Targoff, R.D. Sontheimer.
Autoantibodies to 155 kD and Se autoantigens in patients with clinically–amyopathic dermatomyositis.
Arthritis Rheum, 43 (2000), pp. S194
[69.]
I.N. Targoff, G. Mamyrova, E.P. Trieu, O. Perurena, B. Koneru, T.P. O’Hanlon, et al.
A novel autoantibody to a 155-kd protein is associated with dermatomyositis.
Arthritis Rheum, 54 (2006), pp. 3682-3689
[70.]
I.N. Targoff, E.P. Trieu, M. Levy-Neto, F.W. Miller.
Autoantibodies to transcriptional intermediary factor-1 gamma (TIF-1g) in dermatomyositis (abstract).
Arthritis Rheum, 54 (2006), pp. S518
[71.]
K. Kaji, M. Fujimoto, M. Hasegawa, M. Kondo, Y. Saito, K. Komura, et al.
Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis: An association with malignancy.
Rheumatology (Oxford), 46 (2007), pp. 25-28
[72.]
H. Chinoy, N. Fertig, C.V. Oddis, W.E. Ollier, R.G. Cooper.
The diagnostic utility of myositis autoantibody testing for predicting the risk of cancer-associated myositis.
Ann Rheum Dis, 66 (2007), pp. 1345-1349
[73.]
J.P. Callen.
When and how should the patient with dermatomyositis or amyopathic dermatomyositis be assessed for possible cancer?.
Arch Dermatol, 138 (2002), pp. 969-970
Copyright © 2009. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
Download PDF
Idiomas
Reumatología Clínica (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?