Inflammatory Myopathies with Cutaneous Involvement: from Diagnosis to Therapy

Lyubomir A. Dourmishev 1
  • 1 Department of Dermatology and Venereology, Medical University of Sofia, 1 St Georgi Sofiiski St., 1431 Sofia, Bulgaria

Abstract

The group of idiopathic inflammatory myopathies (IIM) include various disorders of skeletal muscles with or without skin involvement. The most common types are dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM) and necrotizing autoimmune myopathy (NAM). Dermatomyositis subdivides into various clinical forms such as juvenile, amyopathic or paraneoplastic dermatomyositis, scleromyositis, overlap or anti-synthetase syndromes, etc.

Recently, numerous new antibodies defining the characteristic clinical phenotype have been described as anti-MDA5 antibodies associated with interstitial lung disease and amyopathic dermatomyositis or anti-TIF1γ antibodies as markers for paraneoplastic dermatomyositis. Moreover, new clinical entities as drug-induced dermatomyositis are presumed, since some medications may induce, or trigger inflammatory myopathies.

Knowledge of the complex methods and techniques required to diagnose the disease is of great importance in clinical practice. The variety of clinical variants needs diagnosis because of the differing prognosis and therapeutic modalities.

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  • 1. Dalakas MC. Infl ammatory muscle diseases. N Engl J Med 2015;372(18):1734-47.

  • 2. Dourmishev LA, Dourmishev AL, Schwartz RA. Dermatomyositis: cutaneous manifestations of its variants. Int J Dermatol 2002;41(10):625-30.

  • 3. Chen Z, Cao M, Plana MN, et al. Utility of antimelanoma differentiation-associated gene 5 antibody measurement in identifying patients with dermatomyositis and a high risk for developing rapidly progressive interstitial lung disease: a review of the literature and a meta-analysis. Arthritis Care Res (Hoboken) 2013;65:1316-24.

  • 4. Euwer RL, Sontheimer RD. Amyopathic dermatomyositis (dermatomyositis siné myositis). Presentation of six new cases and review of the literature. J Am Acad Dermatol 1991;24(6 Pt 1):959-66.

  • 5. Kamenska V, Dourmishev L, Dourmishev A, et al. Quantitative structure-activity relationship modeling of dermatomyositis activity of drug chemicals. Arzneimittelforschung 2006;56(12):856-65.

  • 6. Targoff IN. Update on myositis-specifi c and myositis- associated autoantibodies. Curr Opin Rheumatol 2000;12:475-81.

  • 7. Talanin NY, Bushore D, Rasberry R, et al. Dermatomyositis with the features of inclusion body myositis associated with carcinoma of the bladder. Br J Dermatol 1999;141(5):926-30.

  • 8. Salajegheh M, Lam T, Greenberg SA. Autoantibodies against a 43 KDa muscle protein in inclusion body myositis. PLoS One 2011;6(5):e20266.

  • 9. Mammen AL. Necrotizing myopathies: beyond statins. Curr Opin Rheumatol 2014;26(6):679-83.

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

  • 11. Meyer A, Meyer N, Schaeffer M, et al. Incidence and prevalence of infl ammatory myopathies: a systematic review. Rheumatology (Oxford) 2015;54(1):50-63.

  • 12. Oddis CV, Conte CG, Steen VD, et al. Incidence of polymyositis-dermatomyositis: a 20-year study of hospital diagnosed cases in Allegheny County, PA 1963-1982. J Rheumatol 1990;17(10):1329-34.

  • 13. Hengstman GJ, van Venrooij WJ, Vencovsky J, et al. The relative prevalence of dermatomyositis and polymyositis in Europe exhibits a latitudinal gradient.Ann Rheum Dis 2000;59(2):141-2.

  • 14. Sarkar K, Weinberg CR, Oddis CV, et al. Seasonal infl uence on the onset of idiopathic infl ammatory myopathies in serologically defi ned groups. Arthritis Rheum 2005;52(8):2433-8.

  • 15. Nishikai M. Coxsackie virus infection and the development of polymyositis/dermatomyositis. Rheumatol Int 1994;14(2):43-6.

  • 16. Chevrel G, Calvet A, Belin V, et al. Dermatomyositis associated with the presence of parvovirus B19 DNA in muscle. Rheumatology (Oxford) 2000;39(9):1037-9.

  • 17. Rider LG, Shamim E, Okada S, et al. Genetic risk and protective factors for idiopathic infl ammatory myopathy in Koreans and American whites: a tale of two loci. Arthritis Rheum 1999;42(6):1285-90.

  • 18. Chinoy H, Adimulam S, Marriage F, et al. Interaction of HLA-DRB1*03 and smoking for the development of anti-Jo-1 antibodies in adult idiopathic infl ammatory myopathies: a European-wide case study. Ann Rheum Dis 2012;71(6):961-5.

  • 19. Werth VP, Callen JP, Ang G, et al. Associations of tumor necrosis factor alpha and HLA polymorphisms with adult dermatomyositis: implications for a unique pathogenesis. J Invest Dermatol 2002;119(3):617-20.

  • 20. Dourmishev LA, Kamenarska Z, Hristova M, et al. Association of TNF-α polymorphisms with adult dermatomyositis and systemic lupus erythematosus in Bulgarian patients. Int J Dermatol 2012;51(12):1467-73.

  • 21. Targoff IN, Miller FW, Medsger TA Jr, et al. Classifi cation criteria for the idiopathic infl ammatory myopathies. Curr Opin Rheumatol 1997;9(6):527-35.

  • 22. Sontheimer RD. Dermatomyositis: an overview of recent progress with emphasis on dermatologic aspects. Dermatol Clin 2002;20(3):387-408.

  • 23. Dourmishev L, Meffert H, Piazena H. Dermatomyositis: comparative studies of cutaneous photosensitivity in lupus erythematosus and normal subjects. Photodermatol Photoimmunol Photomed 2004;20(5):230-4.

  • 24. Riccieri V, Vasile M, Macri V, et al. Successful immunosuppressive treatment of dermatomyositis: a nailfold capillaroscopy survey. J Rheumatol 2010;37(2):443-5.

  • 25. Dourmishev L, Obreshkova E. [Histopathologic changes in skin of dermatomyositis patients.] Dermatol Venereol (Sofi a) 2001;50(1):18-22 [Bulgarian].

  • 26. Panicker JB, Chacko G, Patil AK, et al. Immunohistochemical differentiation of infl ammatory myopathies. Neurol India 2011;59(4):513-20.

  • 27. Bazzani C, Cavazzana I, Ceribelli A, et al. Cardiological features in idiopathic inflammatory myopathies. J Cardiovasc Med (Hagerstown) 2010;11(12):906-11.

  • 28. Dourmishev L, Wollina U, Hipler UC, et al. Myositis- specifi c and myositis-associated autoantibodies in dermatomyositis and polymyositis. Clin Appl Immunol 2006;5(1):533-7.

  • 29. Brouwer R, Hengstman GJ, Vree Egberts W, et al. Autoantibody profiles in the sera of European patients with myositis. Ann Rheum Dis 2001;60(2):116-23.

  • 30. Ghirardello A, Zampieri S, Iaccarino L, et al. [Myositis specifi c and myositis associated autoantibodies in idiopathic infl ammatory myopathies: a serologic study of 46 patients.] Reumatismo 2005;57(1):22-8 [Italian].

  • 31. Ichimura Y, Matsushita T, Hamaguchi Y, et al. Anti- NXP2 autoantibodies in adult patients with idiopathic infl ammatory myopathies: possible association with malignancy. Ann Rheum Dis 2012;71(5):710-3.

  • 32. Sato S, Kuwana M, Fujita T, et al. Anti-CADM-140/ MDA5 autoantibody titer correlates with disease activity and predicts disease outcome in patients with dermatomyositis and rapidly progressive interstitial lung disease. Mod Rheumatol 2013;23(3):496-502.

  • 33. Targoff IN, Mamyrova G, Trieu EP, et al. A novel autoantibody to a 155-kD protein is associated with dermatomyositis. Arthritis Rheum 2006;54(11):3682-9.

  • 34. Labrador-Horrillo M, Martínez MA, Selva- O’Callaghan A, et al. Anti-TIF1γ antibodies (antip155) in adult patients with dermatomyositis: comparison of different diagnostic assays. Ann Rheum Dis 2012;71:993-6.

  • 35. Mammen AL, Chung T, Christopher-Stine L, et al. Autoantibodies against 3-hydroxy-3-methyl- glutaryl- coenzyme a reductase (HMGCR) in patients with statin-associated autoimmune myopathy. Arthritis Rheum 2011;63:713-21.

  • 36. Nistala K, Wedderburn LR. Update in juvenile myositis. Curr Opin Rheumatol 2013;25(6):742-6.

  • 37. Ruperto N, Ravelli A, Murray KJ, et al. Preliminary core sets of measures for disease activity and damage assessment in juvenile systemic lupus erythematosus and juvenile dermatomyositis. Rheumatology (Oxford) 2003;42(12):1452-9.

  • 38. Stertz G. Polymyositis. Berliner Klinische Wochenschrift 1916;53:489.

  • 39. Basset-Seguin N, Roujeau JC, Gherardi R, et al. Prognostic factors and predictive signs of malignancy in adult dermatomyositis. A study of 32 cases. Arch Dermatol 1990;126(5):633-7.

  • 40. Mautner GH, Grossman ME, Silvers DN, et al. Epidermal necrosis as a predictive sign of malignancy in adult dermatomyositis. Cutis 1998;61(4):190-4.

  • 41. Dourmishev LA. Dermatomyositis associated with malignancy. 12 case reports. Adv Exp Med Biol 1999;455:193-9.

  • 42. Chen YJ, Wu CY, Huang YL, et al. Cancer risks of dermatomyositis and polymyositis: a nationwide cohort study in Taiwan. Arthritis Res Ther 2010;12(2):R70.

  • 43. Kannan MA, Sundaram C, Uppin M, et al. Incidence of malignancies in biopsy-proven infl ammatory myopathy. Neurol India 2013;61(2):152-5.

  • 44. Cao H, Parikh TN, Zheng J. Amyopathic dermatomyositis or dermatomyositis-like skin disease: retrospective review of 16 cases with amyopathic dermatomyositis. Clin Rheumatol 2009;28(8):979-84.

  • 45. Walling HW, Gerami P, Sontheimer RD. Juvenileonset clinically amyopathic dermatomyositis: an overview of recent progress in diagnosis and management. Paediatr Drugs 2010;12(1):23-34.

  • 46. Iaccarino L, Gatto M, Bettio S, et al. Overlap connective tissue disease syndromes. Autoimmun Rev 2012;3:363-373.

  • 47. Kim Y, Jung W, Park YH. Dermatomyositis and paclitaxel-induced cutaneous drug eruption associated with metastatic breast cancer. J Breast Cancer 2015;18(2):195-9.

  • 48. Nagashima T, Minota S. Is polymyositis or dermatomyositis in patients with rheumatoid arthritis induced or unveiled by anti-tumor necrosis factor treatment? Clin Rheumatol 2010;29(7):819-20.

  • 49. Liu SW, Velez NF, Lam C, et al. Dermatomyositis induced by anti-tumor necrosis factor in a patient with juvenile idiopathic arthritis. JAMA Dermatol 2013;149(10):1204-8.

  • 50. Dourmishev LA, Dourmishev AL. Activity of certain drugs in inducing of infl ammatory myopathies with cutaneous manifestations. Expert Opinion on Drug Safety 2008;4:421-433.

  • 51. Grable-Esposito P, Katzberg HD, Greenberg SA, et al. Immune-mediated necrotizing myopathy associated with statins. Muscle Nerve 2010;41:185-90.

  • 52. Israeli E, Agmon-Levin N, Blank M, et al. Macrophagic myofasciitis a vaccine (alum) autoimmune- related disease. Clin Rev Allergy Immunol 2011;41:163-8.

  • 53. Katzap E, Barilla-LaBarca ML, Marder G. Antisynthetase syndrome. Curr Rheumatol Rep 2011;13(3):175-81.

  • 54. Betteridge Z, Gunawardena H, North J, et al. Antisynthetase syndrome: a new autoantibody to phenylalanyl transfer RNA synthetase (anti-Zo) associated with polymyositis and interstitial pneumonia. Rheumatology (Oxford) 2007;46(6):1005-8.

  • 55. Villalba L, Adams EM. Update on therapy for refractory dermatomyositis and polymyositis. Curr Opin Rheumatol 1996;8(6):544-51.

  • 56. Hengstman GJ, van den Hoogen FH, van Engelen BG. Treatment of the infl ammatory myopathies: update and practical recommendations. Expert Opin Pharmacother 2009;10(7):1183-90.

  • 57. Tansley S, Shaddick G, Christopher-Stine L, et al. Developing standardized treatment for adults with myositis and different phenotypes: an international survey of current prescribing preferences. Clin Exp Rheumatol 2016;34(5):880-4.

  • 58. Dourmishev LA, Guleva DV, Miteva LG. Intravenous immunoglobulins: mode of action and indications in autoimmune and infl ammatory dermatoses. Int J Inflam 2016;2016:3523057.

  • 59. Ang GC, Werth VP. Combination antimalarials in the treatment of cutaneous dermatomyositis: a retrospective study. Arch Dermatol 2005;141(7):855-9.

  • 60. Park JK, Yoo HG, Ahn DS, et al. Successful treatment for conventional treatment-resistant dermatomyositis- associated interstitial lung disease with adalimumab. Rheumatol Int 2012;32(11):3587-90.

  • 61. Rider LG, Yip AL, Horkayne-Szakaly I, et al. Novel assessment tools to evaluate clinical and laboratory responses in a subset of patients enrolled in the Rituximab in Myositis trial. Clin Exp Rheumatol 2014;32(5):689-96.

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