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Query: UMLS:C0011633 (dermatomyositis)
 4,181 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-seven adult patients with dermatomyositis or polymyositis were retrospectively evaluated over a mean of four and a half years. Eighty-five percent (23) met the suggested criteria of Bohan and Peter (New England Journal of Medicine, 1975) for definite or probable disease, while 15 percent had possible disease. Upper and lower limb girdle strength was given a value (0 to 5) and averaged. Initially, 26 percent were severely weak and 59 percent moderately weak. All patients were treated with steroids. Within three months, 64 percent had little to no weakness and no patients were severely impaired. These proportions remained relatively constant throughout the study. Eight less severely ill patients received alternate-day prednisone. Only two still require treatment; the remainder have been in remission for a mean period of 19 months. Of 19 who received daily prednisone, five also required cytotoxic drugs and 11 still require treatment. A comparison of the results of this study with those of major urban referral centers reveals that the patients in this study constituted a generally less ill population with a better prognosis. Forty-one percent (11) of patients were able to discontinue all forms of therapy and remain in remission. Thirty percent (eight) achieved remission with only alternate-day steroid therapy, an approach that has been discouraged in the past. Two patients (7 percent) had overt malignancies within one year before to three years after diagnosis of myositis. However, in no instance did a search for occult malignancy give positive results. Cancer detection was accomplished by following clues from history and physical examinations. It is questioned whether extensive evaluations for occult malignancies in patients with idiopathic myositis are cost-effective.
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PMID:Presentation, treatment, and prognosis of idiopathic inflammatory muscle disease in a rural hospital. 661 29

Dermatomyositis (DM) has been linked to internal malignancy but this relationship is quite variable in respect to tumor type and time sequence. The occurrence of multiple cancers in an individual with DM is rare. Immunosuppressive agents, particularly methotrexate have been used increasingly in corticosteroid resistant cases or for their corticosteroid sparing effects. These agents have not been implicated in the development of malignancy in patients with DM. A patient with a uterine adenocarcinoma developed DM that despite tumor removal was not responsive to corticosteroids. She was successfully treated with methotrexate for 18 months. She has subsequently developed an adenocarcinoma of the breast. The relationship of malignancy and DM as well as the role of methotrexate in the development of the second primary will be discussed.
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PMID:Dermatomyositis and multiple malignancies in a patient treated with methotrexate. 663 91

Dermatomyositis (DM) is a collagen vascular disease with prominent cutaneous findings. Although the myositis often responds to therapy with corticosteroids and/or immunosuppressives, the cutaneous disease may not respond. Seven patients with cutaneous lesions of DM that had not responded to therapy were treated with hydroxychloroquine in an open study. Three patients had idiopathic DM, one had DM without myositis, one had DM with malignancy, and one had adolescent DM. The response to the addition of hydroxychloroquine was good in all of the patients, and three had total resolution of their skin lesions. In two patients the corticosteroid dosage could be tapered. Therapy with hydroxychloroquine did not appear to have any beneficial effect on the myositis. We conclude that hydroxychloroquine may have a role as an adjuvant to the therapy of patients with cutaneous lesions of DM.
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PMID:Cutaneous lesions of dermatomyositis are improved by hydroxychloroquine. 671 8

The authors present a case of bullous dermatitis with clinical and biological polymyositis. The cause of the blisters can be found in an intense oedema of the superficial and middle dermis and is favoured by liquefaction of the basal layer and fibrinoid degeneration of the superficial dermis. It is diagnosed as dermatomyositis with malignancy even though it has been impossible to confirm the nature of the tumor. The diagnosis is being argued with other diseases that occasionally are vesiculobullous.
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PMID:[Bullous dermatomyositis]. 676 58

Thirty-two patients with polymyositis were categorised into 4 groups: (1) 'pure' polymyositis, (2) dermatomyositis, (3) myositis associated with autoimmune 'overlap syndrome', and (4) those with associated malignancy. Serum from each patient was examined for a range of antinuclear antibodies. Seventeen patients had ANA detected by immunofluorescence, 18 patients had raised DNA binding (greater than 25 U/ml), of whom eight had levels greater than 50 U/ml (SI conversion: U/l = U/ml x 10(3)). Antibodies to soluble nuclear antigens were detected in 23 (72%) by 1 or more of 3 methods, and in all of these anti-RNP was the main antibody detected. Antibodies to other soluble antigens were also present in 6 sera. In 2 cases, both patients with SLE/myositis overlap, these were shown to be anti-Sm. The remaining 4 had antibodies to various protein components of the extracts, but it was not possible to demonstrate an antibody of diagnostic specificity for polymyositis. Furthermore, quantitation of anti-RNP and anti-DNA antibodies failed to define a distinct clinical entity or exclude malignant disease. High levels of anti-RNP antibodies showed an association with Raynaud's phenomenon, sclerodactyly, and pulmonary fibrosis and an inverse correlation with the rash of dermatomyositis, suggesting that this antibody may be of pathogenetic rather than diagnostic significance.
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PMID:Antibodies to nuclear antigens in polymyositis: relationship to autoimmune 'overlap syndromes' and carcinoma. 678 93

A patient with dermatomyositis developed malignant transformation of the benign interfascial heterotopic bone. This patient had classic childhood dermatomyositis at the age of 3 years, and the disease was arrested after a one-year course of corticosteroid therapy. Extensive subcutaneous calcinosis cutis and deep interfascial calcinosis were the residua of the disease. Twenty-eight years later, the patient developed a high-grade osteosarcoma within the benign intermuscular heterotopic calcification and ossification that had been previously documented at the age of 8 years by a roentgenogram and at the age of 16 years by biopsy. This case represents the first report of the association of osteosarcoma and dermatomyositis, and possibly the first well-documented case of malignant transformation of benign heterotopic bone.
Cancer 1981 Sep 01
PMID:Osteosarcoma arising in heterotopic ossification of dermatomyositis: case report and review of the literature. 679 7

A young man developed metastatic melanoma and classic dermatomyositis. With surgical extirpation of the metastasis, the dermatomyositis resolved only to reccur simultaneously with further metastases. To the knowledge of the authors, this case represents the best-documented parallel course of these two diseases.
Cancer 1983 Jun 01
PMID:Dermatomyositis associated with malignant melanoma. Parallel occurrence, remission, and relapse of the two processes in a patient. 683 4

Seven (9.2%) of 76 patients with adult-onset polymyositis/dermatomyositis (PM/DM) seen over an 11-year period had cutaneous vasculitis. This was manifest by dermal and/or subcutaneous nodules in 4, periungual infarcts in 3 and digital ulceration in 2. When these 7 patients were compared to the remaining 69, a significant association was noted between cutaneous vasculitis and DM (p = .025); only 1 of 31 patients with primary PM and none of 18 with overlap syndromes had vasculitis. Furthermore, 2 (28.6%) of those with vasculitis had an associated malignancy compared to only 4 (5.8%) of those without vasculitis. These data document the occurrence of cutaneous vasculitis in adult-onset PM/DM and suggest that its presence may be a marker of an underlying malignancy.
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PMID:Cutaneous vasculitis in adult polymyositis/dermatomyositis. 684 91

The more common paraneoplastic skin changes associated with internal malignancies (acanthosis nigricans, dermatomyositis, secondary ichthyosis) are discussed. The rare glucagonoma syndrome, consisting of alpha cell tumor of the pancreas, migratory necrolytic erythema, and diabetes mellitus, is described. The importance of recognition of these skin lesions may lead to early detection of the underlying cancer with possible cure.
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PMID:Cutaneous signs of internal malignancies. 684 28

In a 58-year-old man with the clinical and radiological signs of definite ankylosing spondylitis in its final stages, HLA B 27 positive, an onset of dermatomyositis was observed with characteristic clinical, histological, and pathological findings, and with high titers of ANA. It had been discovered years before that a gouty kidney with pyelonephritis accompanied the advanced ankylosing spondylitis. On the basis of these findings a triple association of etiologically different diseases could be diagnosed. After treatment with cortisone, allopurinol, and azathioprine appeared an acute and no longer controllable panmyelophthisis. That a malignant tumor could have caused the dermatomyositis was excluded by autopsy. Diagnostic questions concerning the gouty kidney as well as factors explaining the acute and deadly progress of a panmyelophthisis after the administration of a rather mild immunosuppressive agent are discussed.
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PMID:[Combination of ankylosing spondylitis with dermatomyositis and atypical gout (isolated gout kidney)]. 684 89


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