nach oben

Current Dermatology Reports

Erschienen in:

01.05.2023 | REVIEW

Dermatomyositis Diagnosis and Treatment in the Inpatient Setting

verfasst von: Emily Z. Hejazi, Lavanya Mittal, Kristen Lo Sicco, Daniel R. Mazori, Alisa N. Femia, Avrom S. Caplan

Erschienen in: Current Dermatology Reports | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Dermatomyositis can present with a range of manifestations and severity that may necessitate hospital admission. Dermatologists are frequently consulted for patients with dermatomyositis inpatient. Herein we describe clinical features and management of multisystem complications of dermatomyositis with a focus on the inpatient setting.

Recent Findings

Patients with dermatomyositis are at risk for hospitalization due to disease flares, infections, and systemic complications. Furthermore, patients may seek care for symptoms including shortness of breath, fever, or cutaneous eruptions which can lead to a new diagnosis of dermatomyositis. Patients with dermatomyositis have increased healthcare utilization and necessitate multidisciplinary and collaborative care. Cutaneous findings may be subtle yet provide important prognostic information. Symptoms arising from skin disease may also be chronic and refractory.

Summary

Dermatologists are essential in both diagnosing and managing dermatomyositis and must be attuned to the multiple systemic manifestations and complications that impact inpatient care.

Bendewald MJ, Wetter DA, Li X, Davis MD. Incidence of dermatomyositis and clinically amyopathic dermatomyositis: a population-based study in Olmsted County. Minnesota Arch Dermatol. 2010;146(1):26–30.PubMedCrossRef

• Ungprasert P, Wannarong T, Cheungpasitporn W, Wijarnpreecha K, Thongprayoon C, Kroner PT. Inpatient burden and resource utilization of polymyositis and dermatomyositis: A 10-year Study of National Inpatient Sample. Joint Bone Spine. 2020;87(4):327–30. Large database study finding that the inpatient prevalence of polymyositis and dermatomyositis over a 10-year period from 2005-2014 is higher than that which would be expected by incidence, and determining that the the associated rates of mortality, morbidity, and resource utilization among this group of inpatients is higher relative to those of other hospitalized patients.PubMedCrossRef

Ren Z, Laumann AE, Silverberg JI. Association of dermatomyositis with systemic and opportunistic infections in the United States. Arch Dermatol Res. 2019;311(5):377–87.PubMedCrossRef

Gutierrez D, Svigos K, Femia A, Brinster NK, Lo SK. Prominent dyspigmentation in a patient with dermatomyositis and TIF1-gamma autoantibodies. JAAD Case Rep. 2022;22:107–9.PubMedPubMedCentralCrossRef

Bradford Rice J, White A, Lopez A, Galebach P, Schepman P, Popelar B, et al. Healthcare resource utilization and work loss in dermatomyositis and polymyositis patients in a privately-insured US population. J Med Econ. 2016;19(7):649–54.PubMedCrossRef

• Cobos GA, Femia A, Vleugels RA. Dermatomyositis: an update on diagnosis and treatment. Am J Clin Dermatol. 2020;21(3):339–53. Review discussing the diagnosis of dermatomyositis, with a focus on phenotypes associated with various myositis-specific antibodies, as well as therapies for refractory skin disease.PubMedCrossRef

Qiang JK, Kim WB, Baibergenova A, Alhusayen R. Risk of Malignancy in Dermatomyositis and Polymyositis. J Cutan Med Surg. 2017;21(2):131–6.PubMedCrossRef

• Tripathi R, Fernandez AP. Characteristics of hospitalized dermatomyositis patients with underlying malignancy: a nationally representative retrospective cohort study. Arch Dermatol Res. 2021;313(6):473–82. Database study finding that hospitalized dermatomyositis patients with malignancy were more likely to be older than 40, female, and socioeconomically different than hospitalized dermatomyositis patients without malignancy. The study also found that the economic cost of hospitalized dermatomyositis patients is increasing.PubMedCrossRef

Chandrakasan S, Singh S, Ratho RK, Kumar S, Mishra B. Anasarca as the presenting manifestation of parvovirus B19 associated juvenile dermatomyositis. Rheumatol Int. 2009;29(5):565–7.PubMedCrossRef

10.

Shukla M, Patel R, Kuzyshyn H, Feinstein D. Subcutaneous oedema of upper limbs heralding an aggressive form of dermatomyositis. BMJ Case Rep. 2018;2018.

11.

Chai Y, Bertorini TE, Li YD, Mitchell C, Guan H. Limb edema and anasarca associated with severe dermatomyositis: report of four cases. Neuromuscul Disord. 2011;21(6):439–42.PubMedCrossRef

12.

Jung KD, Kim PS, Park HY, Kim CR, Byun JY, Lee DY, et al. Dermatomyositis associated with generalized subcutaneous edema and Evans syndrome. J Am Acad Dermatol. 2012;66(1):144–7.PubMedCrossRef

13.

Zarrabi K, Choy T, Sweeney K, Desai V, Keresztes R. Paraneoplastic edematous dermatomyositis: A rare syndrome observed in a case of small cell lung cancer. Clin Pract. 2017;7(4):982.PubMedPubMedCentralCrossRef

14.

Werner de Castro GR, Appenzeller S, Bertolo MB, Costallat LT. Acute dermatomyositis with subcutaneous generalized edema. Clin Rheumatol. 2006;25(6):898–900.

15.

Concha JSS, Merola JF, Fiorentino D, Werth VP. Re-examining mechanic’s hands as a characteristic skin finding in dermatomyositis. J Am Acad Dermatol. 2018;78(4):769-75.e2.PubMedCrossRef

16.

Sohara E, Saraya T, Sato S, Tsujimoto N, Watanabe T, Takata S, et al. Mechanic’s hands revisited: is this sign still useful for diagnosis in patients with lung involvement of collagen vascular diseases? BMC Res Notes. 2014;7:303.PubMedPubMedCentralCrossRef

17.

Herath H, Keragala B, Pahalagamage SP, Janappriya G, Kulatunga A, Gunasekera CN. Erythroderma and extensive poikiloderma - a rare initial presentation of dermatomyositis: a case report. J Med Case Rep. 2018;12(1):83.PubMedPubMedCentralCrossRef

18.

Kim SW, Kang YS, Park SH, Lee UH, Park HS, Jang SJ. A case of erythrodermic dermatomyositis associated with gastric cancer. Ann Dermatol. 2009;21(4):435–9.PubMedPubMedCentralCrossRef

19.

Ge W, Teng BW, Yu DC, Chen G, Zheng LM, Ding YT. Dermatosis as the initial presentation of gastric cancer: two cases. Chin J Cancer Res. 2014;26(5):632–8.PubMedPubMedCentral

20.

Miyagawa S, Okazaki A, Minowa R, Shirai T. Dermatomyositis presenting as erythroderma. J Am Acad Dermatol. 1992;26(3 Pt 2):489–90.PubMedCrossRef

21.

Liu ZH, Wang XD. Acute-onset adult dermatomyositis presenting with erythroderma and diplopia. Clin Exp Dermatol. 2007;32(6):751–2.PubMedCrossRef

22.

Nousari HC, Kimyai-Asadi A, Spegman DJ. Paraneoplastic dermatomyositis presenting as erythroderma. J Am Acad Dermatol. 1998;39(4 Pt 1):653–4.PubMedCrossRef

23.

Valdes-Gonzalez G, Chavez-Lopez M, Gallaga-Gutierrez A, Reyes-Garcia A. Dermatomyositis-erythrodermia: clinical presentation not associated to malignancy. A case report Reumatol Clin. 2014;10(1):48–50.PubMed

24.

Lundberg IE, Tjarnlund A, Bottai M, Werth VP, Pilkington C, de Visser M, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Arthritis Rheumatol. 2017;69(12):2271–82.PubMedPubMedCentralCrossRef

25.

Concha JSS, Pena S, Gaffney RG, Patel B, Tarazi M, Kushner CJ, et al. Developing classification criteria for skin-predominant dermatomyositis: the Delphi process. Br J Dermatol. 2020;182(2):410–7.PubMedCrossRef

26.

Moghadam-Kia S, Oddis CV, Sato S, Kuwana M, Aggarwal R. Antimelanoma differentiation-associated gene 5 antibody: expanding the clinical spectrum in North American patients with dermatomyositis. J Rheumatol. 2017;44(3):319–25.PubMedCrossRef

27.

Fiorentino D, Chung L, Zwerner J, Rosen A, Casciola-Rosen L. The mucocutaneous and systemic phenotype of dermatomyositis patients with antibodies to MDA5 (CADM-140): a retrospective study. J Am Acad Dermatol. 2011;65(1):25–34.PubMedPubMedCentralCrossRef

28.

Narang NS, Casciola-Rosen L, Li S, Chung L, Fiorentino DF. Cutaneous ulceration in dermatomyositis: association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease. Arthritis Care Res (Hoboken). 2015;67(5):667–72.PubMedCrossRef

29.

Cao H, Xia Q, Pan M, Zhao X, Li X, Shi R, et al. Gottron papules and Gottron sign with ulceration: a distinctive cutaneous feature in a subset of patients with classic dermatomyositis and clinically amyopathic dermatomyositis. J Rheumatol. 2016;43(9):1735–42.PubMedCrossRef

30.

Kurtzman DJB, Vleugels RA. Anti-melanoma differentiation-associated gene 5 (MDA5) dermatomyositis: A concise review with an emphasis on distinctive clinical features. J Am Acad Dermatol. 2018;78(4):776–85.PubMedCrossRef

31.

Bailey EE, Fiorentino DF. Amyopathic dermatomyositis: definitions, diagnosis, and management. Curr Rheumatol Rep. 2014;16(12):465.PubMedCrossRef

32.

Adams EM, Chow CK, Premkumar A, Plotz PH. The idiopathic inflammatory myopathies: spectrum of MR imaging findings. Radiographics. 1995;15(3):563–74.PubMedCrossRef

33.

Ahmed S, Concha JSS, Chakka S, Krain RL, Zamalin D, Foulke G, et al. Diagnosing muscle disease in a cohort of classic dermatomyositis patients seen at a rheumatologic dermatology outpatient clinic. J Am Acad Dermatol. 2022;86(3):544–50.PubMedCrossRef

34.

Schempp CM, Schauer F, Huhn CK, Venhoff N, Finzel S. Skin inflammation associated with arthritis, synovitis and enthesitis. Part 2: rheumatoid arthritis, reactive arthritis, Reiter's syndrome, Lyme borreliosis, dermatomyositis and lupus erythematosus. J Dtsch Dermatol Ges. 2019;17(2):167–81.

35.

Mugii N, Hasegawa M, Matsushita T, Hamaguchi Y, Oohata S, Okita H, et al. Oropharyngeal dysphagia in dermatomyositis: associations with clinical and laboratory features including autoantibodies. PLoS ONE. 2016;11(5): e0154746.PubMedPubMedCentralCrossRef

36.

Rogers A, Chung L, Li S, Casciola-Rosen L, Fiorentino DF. Cutaneous and systemic findings associated with nuclear matrix protein 2 antibodies in adult dermatomyositis patients. Arthritis Care Res (Hoboken). 2017;69(12):1909–14.PubMedCrossRef

37.

Ebert EC. Review article: the gastrointestinal complications of myositis. Aliment Pharmacol Ther. 2010;31(3):359–65.PubMedCrossRef

38.

Williams RB, Grehan MJ, Hersch M, Andre J, Cook IJ. Biomechanics, diagnosis, and treatment outcome in inflammatory myopathy presenting as oropharyngeal dysphagia. Gut. 2003;52(4):471–8.PubMedPubMedCentralCrossRef

39.

Oh TH, Brumfield KA, Hoskin TL, Stolp KA, Murray JA, Bassford JR. Dysphagia in inflammatory myopathy: clinical characteristics, treatment strategies, and outcome in 62 patients. Mayo Clin Proc. 2007;82(4):441–7.PubMedCrossRef

40.

Schmidt J. Current classification and management of inflammatory myopathies. J Neuromuscul Dis. 2018;5(2):109–29.PubMedPubMedCentralCrossRef

41.

Couvrat-Desvergnes G, Masseau A, Benveniste O, Bruel A, Hervier B, Mussini JM, et al. The spectrum of renal involvement in patients with inflammatory myopathies. Medicine (Baltimore). 2014;93(1):33–41.PubMedCrossRef

42.

Yen TH, Lai PC, Chen CC, Hsueh S, Huang JY. Renal involvement in patients with polymyositis and dermatomyositis. Int J Clin Pract. 2005;59(2):188–93.PubMedCrossRef

43.

Akashi Y, Inoh M, Gamo N, Kinashi M, Ohbayashi S, Miyake H, et al. Dermatomyositis associated with membranous nephropathy in a 43-year-old female. Am J Nephrol. 2002;22(4):385–8.PubMedCrossRef

44.

Civilibal M, Selcuk Duru N, Ozagari A, Durali K, Elevli M. Immunoglobulin A nephropathy associated with juvenile dermatomyositis. Pediatr Nephrol. 2009;24(10):2073–5.PubMedCrossRef

45.

Makino H, Hirata K, Matsuda M, Amano T, Ota Z. Membranous nephropathy developing during the course of dermatomyositis. J Rheumatol. 1994;21(7):1377–8.PubMed

46.

Kaneoka H, Sasatomi Y, Miyagi K, Kiyoshi Y, Takeda S, Takebayashi S, et al. A rare case of dermatomyositis associated with immune-complex type glomerulonephritis, idiopathic thrombopenic purpura, pulmonary fibrosis and lung cancer. Clin Exp Rheumatol. 2003;21(6):801–2.PubMed

47.

Moriyama T, Uruta Y, Yamaguchi H, Fukuzaki M, Uchida Y, Yasumoto Y, et al. A case of immune-complex type glomerulonephritis associated with dermatomyositis. Nippon Naika Gakkai Zasshi. 1989;78(7):994–5.PubMedCrossRef

48.

Cucchiari D, Angelini C. Renal involvement in idiopathic inflammatory myopathies. Clin Rev Allergy Immunol. 2017;52(1):99–107.PubMedCrossRef

49.

Yuste C, Rapalai M, Pritchard BA, Jones TJ, Amoasii C, Al-Ansari A, et al. Overlap between dermatomyositis and ANCA vasculitides. Clin Kidney J. 2014;7(1):59–61.PubMedCrossRef

50.

Xiong A, Hu Z, Zhou S, Qiang Y, Song Z, Chen H, et al. Cardiovascular events in adult polymyositis and dermatomyositis: a meta-analysis of observational studies. Rheumatology (Oxford). 2022;61(7):2728–39.PubMedCrossRef

51.

Yafasova A, Diederichsen LP, Schou M, Sun G, Torp-Pedersen C, Gislason GH, et al. Increased long-term risk of heart failure and other adverse cardiac outcomes in dermatomyositis and polymyositis: Insights from a nationwide cohort. J Intern Med. 2021;290(3):704–14.PubMedCrossRef

52.

Danieli MG, Gambini S, Pettinari L, Logullo F, Veronesi G, Gabrielli A. Impact of treatment on survival in polymyositis and dermatomyositis. A single-centre long-term follow-up study. Autoimmun Rev. 2014;13(10):1048–54.

53.

Danieli MG, Gelardi C, Guerra F, Cardinaletti P, Pedini V, Gabrielli A. Cardiac involvement in polymyositis and dermatomyositis. Autoimmun Rev. 2016;15(5):462–5.PubMedCrossRef

54.

Zhang L, Wang GC, Ma L, Zu N. Cardiac involvement in adult polymyositis or dermatomyositis: a systematic review. Clin Cardiol. 2012;35(11):686–91.PubMed

55.

Strowd LC, Jorizzo JL. Review of dermatomyositis: establishing the diagnosis and treatment algorithm. J Dermatolog Treat. 2013;24(6):418–21.PubMedCrossRef

56.

Hundley JL, Carroll CL, Lang W, Snively B, Yosipovitch G, Feldman SR, et al. Cutaneous symptoms of dermatomyositis significantly impact patients’ quality of life. J Am Acad Dermatol. 2006;54(2):217–20.PubMedCrossRef

57.

Goreshi R, Chock M, Foering K, Feng R, Okawa J, Rose M, et al. Quality of life in dermatomyositis. J Am Acad Dermatol. 2011;65(6):1107–16.PubMedPubMedCentralCrossRef

58.

• Pinard J, Femia AN, Roman M, Alsarheed A, Joyce C, Lin J, et al. Systemic treatment for clinically amyopathic dermatomyositis at 4 tertiary care centers. JAMA Dermatol. 2019;155(4):494–6. Retrospective study examining systemic treatments for clinically amyopathic dermatomyositis at 4 tertiary care centers.PubMedPubMedCentralCrossRef

59.

Pelle MT, Callen JP. Adverse cutaneous reactions to hydroxychloroquine are more common in patients with dermatomyositis than in patients with cutaneous lupus erythematosus. Arch Dermatol. 2002;138(9):1231–3; discussion 3.

60.

Anyanwu CO, Chansky PB, Feng R, Carr K, Okawa J, Werth VP. The systemic management of cutaneous dermatomyositis: results of a stepwise strategy. Int J Womens Dermatol. 2017;3(4):189–94.PubMedPubMedCentralCrossRef

61.

Wolstencroft PW, Fiorentino DF. Dermatomyositis clinical and pathological phenotypes associated with myositis-specific autoantibodies. Curr Rheumatol Rep. 2018;20(5):28.PubMedCrossRef

62.

Wolstencroft PW, Casciola-Rosen L, Fiorentino DF. Association between autoantibody phenotype and cutaneous adverse reactions to hydroxychloroquine in dermatomyositis. JAMA Dermatol. 2018;154(10):1199–203.PubMedPubMedCentralCrossRef

63.

• Waldman R, DeWane ME, Lu J. Dermatomyositis: diagnosis and treatment. J Am Acad Dermatol. 2020;82(2):283–96. A review paper discussing initial evaluation in patients suspected of having dermatomyositis, the recommended work-up for malignancy and interstitial lung disease following diagnosis, and treatment options based on disease severity and extent of systemic involvement.PubMedCrossRef

64.

Hornung T, Ko A, Tuting T, Bieber T, Wenzel J. Efficacy of low-dose methotrexate in the treatment of dermatomyositis skin lesions. Clin Exp Dermatol. 2012;37(2):139–42.PubMedCrossRef

65.

Kolla AM, Liu L, Shaw K, Shapiro J, Femia A, Lo SK. A narrative review of therapies for scalp dermatomyositis. Dermatol Ther. 2021;34(6): e15138.PubMedCrossRef

66.

Lam C, Vleugels RA. Management of cutaneous dermatomyositis. Dermatol Ther. 2012;25(2):112–34.PubMedCrossRef

67.

Hayashi M, Kikuchi T, Takada T. Mycophenolate mofetil for the patients with interstitial lung diseases in amyopathic dermatomyositis with anti-MDA-5 antibodies. Clin Rheumatol. 2017;36(1):239–40.PubMedCrossRef

68.

Bounfour T, Bouaziz JD, Bezier M, Cordoliani F, Saussine A, Petit A, et al. Clinical efficacy of intravenous immunoglobulins for the treatment of dermatomyositis skin lesions without muscle disease. J Eur Acad Dermatol Venereol. 2014;28(9):1150–7.PubMedCrossRef

69.

Femia AN, Eastham AB, Lam C, Merola JF, Qureshi AA, Vleugels RA. Intravenous immunoglobulin for refractory cutaneous dermatomyositis: a retrospective analysis from an academic medical center. J Am Acad Dermatol. 2013;69(4):654–7.PubMedCrossRef

70.

Oddis CV, Reed AM, Aggarwal R, Rider LG, Ascherman DP, Levesque MC, et al. Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial. Arthritis Rheum. 2013;65(2):314–24.PubMedPubMedCentralCrossRef

71.

Kotani T, Makino S, Takeuchi T, Kagitani M, Shoda T, Hata A, et al. Early intervention with corticosteroids and cyclosporin A and 2-hour postdose blood concentration monitoring improves the prognosis of acute/subacute interstitial pneumonia in dermatomyositis. J Rheumatol. 2008;35(2):254–9.PubMed

72.

Shimojima Y, Ishii W, Matsuda M, Kishida D, Ikeda SI. Effective use of calcineurin inhibitor in combination therapy for interstitial lung disease in patients with dermatomyositis and polymyositis. J Clin Rheumatol. 2017;23(2):87–93.PubMedCrossRef

73.

Riolo G, Towheed TE. Anti-tumor necrosis factor inhibitor therapy-induced dermatomyositis and fasciitis. J Rheumatol. 2012;39(1):192–4.PubMed

74.

Klein R, Rosenbach M, Kim EJ, Kim B, Werth VP, Dunham J. Tumor necrosis factor inhibitor-associated dermatomyositis. Arch Dermatol. 2010;146(7):780–4.PubMedPubMedCentralCrossRef

75.

Dastmalchi M, Grundtman C, Alexanderson H, Mavragani CP, Einarsdottir H, Helmers SB, et al. A high incidence of disease flares in an open pilot study of infliximab in patients with refractory inflammatory myopathies. Ann Rheum Dis. 2008;67(12):1670–7.PubMedCrossRef

76.

Kato M, Ikeda K, Kageyama T, Kasuya T, Kumagai T, Furuya H, et al. Successful treatment for refractory interstitial lung disease and pneumomediastinum with multidisciplinary therapy including tofacitinib in a patient with anti-MDA5 antibody-positive dermatomyositis. J Clin Rheumatol. 2021;27(8S):S574–7.PubMedCrossRef

77.

Paudyal A, Zheng M, Lyu L, Thapa C, Gong S, Yang Y, et al. JAK-inhibitors for dermatomyositis: a concise literature review. Dermatol Ther. 2021;34(3): e14939.PubMedCrossRef

78.

Werth VP, Hejazi E, Pena SM, Haber J, Zeidi M, Reddy N, et al. Safety and efficacy of lenabasum, a cannabinoid receptor type 2 agonist, in patients with dermatomyositis with refractory skin disease: a randomized clinical trial. J Invest Dermatol. 2022;142(10):2651–9 e1.

79.

Priovant Therapeutics I. A study to investigate the efficacy and safety of brepocitinib in adults with dermatomyositis. https://ClinicalTrials.gov/show/NCT05437263; 2022.

80.

Aggarwal R, Loganathan P, Koontz D, Qi Z, Reed AM, Oddis CV. Cutaneous improvement in refractory adult and juvenile dermatomyositis after treatment with rituximab. Rheumatology (Oxford). 2017;56(2):247–54.PubMedCrossRef

81.

Argobi Y, Smith GP. Tracking changes in nailfold capillaries during dermatomyositis treatment. J Am Acad Dermatol. 2019;81(1):275–6.PubMedCrossRef

82.

Clottu A, Laffitte E, Prins C, Chizzolini C. Response of mucocutaneous lesions to rituximab in a case of melanoma differentiation antigen 5-related dermatomyositis. Dermatology. 2012;225(4):376–80.PubMedCrossRef

83.

Combalia A, Giavedoni P, Tamez L, Grau-Junyent JM, Mascaro JM Jr. Bosentan for Cutaneous Ulcers in Anti-MDA5 Dermatomyositis. JAMA Dermatol. 2018;154(3):371–3.PubMedCrossRef

84.

Min HK, Kim HR, Lee SH, Park SH, Oh J, Choi K. Refractory Digital Ulcers Treated by Botulinum Toxin and Endothelin Receptor-1 Antagonist in Anti-MDA5-Antibody-Positive Dermatomyositis. J Clin Neurol. 2020;16(1):160–2.PubMedCrossRef

85.

Zhong J, Lan Y, Fu S, Zhang J, Lu S, He Y, et al. Botulinum toxin A injection for treatment of chronic skin ulcer: a case series and literature review. Int J Low Extrem Wounds. 2019;18(1):97–103.PubMedCrossRef

86.

Hoeltzel MF, Oberle EJ, Robinson AB, Agarwal A, Rider LG. The presentation, assessment, pathogenesis, and treatment of calcinosis in juvenile dermatomyositis. Curr Rheumatol Rep. 2014;16(12):467.PubMedPubMedCentralCrossRef

87.

Reiter N, El-Shabrawi L, Leinweber B, Berghold A, Aberer E. Calcinosis cutis: part II. Treatment options. J Am Acad Dermatol. 2011;65(1):15–22; quiz 3–4.

88.

Dalakas MC. Immunotherapy of myositis: issues, concerns and future prospects. Nat Rev Rheumatol. 2010;6(3):129–37.PubMedCrossRef

89.

Sasaki H, Kohsaka H. Current diagnosis and treatment of polymyositis and dermatomyositis. Mod Rheumatol. 2018;28(6):913–21.PubMedCrossRef

90.

Isak V, Jorizzo JL. Recent developments on treatment strategies and the prognosis of dermatomyositis: a review. J Dermatolog Treat. 2018;29(5):450–9.PubMedCrossRef

91.

Findlay AR, Goyal NA, Mozaffar T. An overview of polymyositis and dermatomyositis. Muscle Nerve. 2015;51(5):638–56.PubMedCrossRef

92.

Distad BJ, Amato AA, Weiss MD. Inflammatory myopathies. Curr Treat Options Neurol. 2011;13(2):119–30.PubMedCrossRef

93.

Matsubara S, Sawa Y, Takamori M, Yokoyama H, Kida H. Pulsed intravenous methylprednisolone combined with oral steroids as the initial treatment of inflammatory myopathies. J Neurol Neurosurg Psychiatry. 1994;57(8):1008.PubMedPubMedCentralCrossRef

94.

Raghu P, Manadan AM, Schmukler J, Mathur T, Block JA. Pulse Dose Methylprednisolone Therapy for Adult Idiopathic Inflammatory Myopathy. Am J Ther. 2015;22(4):244–7.PubMedCrossRef

95.

• Lupsa BC, Insogna KL, Micheletti RG, Caplan A. Corticosteroid use in chronic dermatologic disorders and osteoporosis. Int J Womens Dermatol. 2021;7(5Part A):545–51. A review with vase vignettes examining the approach to anticipating and preventing glucocorticoid-induced osteoporosis in patients being treated with glucocorticoids for dermatologic diseases.

96.

Caplan A, Fett N, Rosenbach M, Werth VP, Micheletti RG. Prevention and management of glucocorticoid-induced side effects: A comprehensive review: Infectious complications and vaccination recommendations. J Am Acad Dermatol. 2017;76(2):191–8.PubMedCrossRef

97.

Caplan A, Fett N, Rosenbach M, Werth VP, Micheletti RG. Prevention and management of glucocorticoid-induced side effects: a comprehensive review: a review of glucocorticoid pharmacology and bone health. J Am Acad Dermatol. 2017;76(1):1–9.PubMedCrossRef

98.

Zhang Y, Milojevic D. Protecting bone health in pediatric rheumatic diseases: pharmacological considerations. Paediatr Drugs. 2017;19(3):193–211.PubMedCrossRef

99.

Cox M, Sandler RD, Matucci-Cerinic M, Hughes M. Bone health in idiopathic inflammatory myopathies. Autoimmun Rev. 2021;20(4): 102782.PubMedCrossRef

100.

Caplan A, Fett N, Rosenbach M, Werth VP, Micheletti RG. Prevention and management of glucocorticoid-induced side effects: A comprehensive review: ocular, cardiovascular, muscular, and psychiatric side effects and issues unique to pediatric patients. J Am Acad Dermatol. 2017;76(2):201–7.PubMedCrossRef

101.

Hsu HC, Chang YS, Hou TY, Chen LF, Hu LF, Lin TM, et al. Pneumocystis jirovecii pneumonia in autoimmune rheumatic diseases: a nationwide population-based study. Clin Rheumatol. 2021;40(9):3755–63.PubMedPubMedCentralCrossRef

102.

Jagannathan M. The infectious danger of corticosteroids: a fatal case of Pneumocystis jirovecii pneumonia in a non-HIV patient following corticosteroid use with prophylaxis. Cureus. 2019;11(10): e5874.PubMedPubMedCentral

103.

Limper AH, Knox KS, Sarosi GA, Ampel NM, Bennett JE, Catanzaro A, et al. An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients. Am J Respir Crit Care Med. 2011;183(1):96–128.PubMedCrossRef

104.

Ruperto N, Pistorio A, Oliveira S, Zulian F, Cuttica R, Ravelli A, et al. Prednisone versus prednisone plus ciclosporin versus prednisone plus methotrexate in new-onset juvenile dermatomyositis: a randomised trial. Lancet. 2016;387(10019):671–8.PubMedCrossRef

105.

Newman ED, Scott DW. The use of low-dose oral methotrexate in the treatment of polymyositis and dermatomyositis. J Clin Rheumatol. 1995;1(2):99–102.PubMedCrossRef

106.

Moghadam-Kia S, Aggarwal R, Oddis CV. Treatment of inflammatory myopathy: emerging therapies and therapeutic targets. Expert Rev Clin Immunol. 2015;11(11):1265–75.PubMedPubMedCentralCrossRef

107.

Leatham H, Schadt C, Chisolm S, Fretwell D, Chung L, Callen JP, et al. Evidence supports blind screening for internal malignancy in dermatomyositis: data from 2 large US dermatology cohorts. Medicine (Baltimore). 2018;97(2): e9639.PubMedCrossRef

108.

Sigurgeirsson B, Lindelof B, Edhag O, Allander E. Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N Engl J Med. 1992;326(6):363–7.

109.

Corrado B, Ciardi G, Lucignano L. Supervised physical therapy and polymyositis/dermatomyositis-a systematic review of the literature. Neurol Int. 2020;12(3):77–88.PubMedPubMedCentralCrossRef

Titel: Dermatomyositis Diagnosis and Treatment in the Inpatient Setting
verfasst von: Emily Z. Hejazi
Lavanya Mittal
Kristen Lo Sicco
Daniel R. Mazori
Alisa N. Femia
Avrom S. Caplan
Publikationsdatum: 01.05.2023
Verlag: Springer US
Erschienen in: Current Dermatology Reports / Ausgabe 2/2023
Elektronische ISSN: 2162-4933
DOI: https://doi.org/10.1007/s13671-023-00389-6

Leitlinien kompakt für die Dermatologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Dermatologie

Studienlage spricht für Isotretinoin zur Rosazea-Therapie

23.05.2024 Rosazea Nachrichten

Isotretinoin wird off-label zur Behandlung von Rosazea eingesetzt. Wie solide die Evidenz dafür ist, wurde jetzt in einem systematischen Review überprüft.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Riesenzellarteriitis: 15% der Patienten sind von okkulter Form betroffen

16.05.2024 Riesenzellarteriitis Nachrichten

In einer retrospektiven Untersuchung haben Forschende aus Belgien und den Niederlanden die okkulte Form der Riesenzellarteriitis genauer unter die Lupe genommen. In puncto Therapie und Rezidivraten stellten sie keinen sehr großen Unterschied zu Erkrankten mit kranialen Symptomen fest.

Update Dermatologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Bildnachweise

Die Leitlinien für Ärztinnen und Ärzte, Nahaufnahme Rosazea auf der Wange/© Alessandro Grandini / stock.adobe.com (Symbolbild mit Fotomodell), Eine Tätowierung wird mit roter Farbe ausgefüllt/© nagaets / stock.adobe.com (Symbolbild mit Fotomodell), Operation/© Peakstock / Stock.adobe.com (Symbolbild mit Fotomodellen), Rechte Aa. carotis interna mit Wandverdickung bei Riesenzellarteriitis/© Kisyova H et al. | all rights reserved Springer Medizin Verlag GmbH

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2023

Emerging Fungal Infections and Cutaneous Manifestations in Immunosuppressed Patients

The Impact of Immune-Modulating Treatments for Dermatological Diseases on the Risk of Infection with SARS-CoV-2 and Outcomes Associated with COVID-19 Illness

Contact Dermatitis to Isothiazolinone Preservatives

Skin Cancer, Climate Change, and Opportunities for Dermatologists

Lessons Learned from Anatomic Susceptibility in Vitiligo Patients: A Systematic Review