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Malignancy in dermatomyositis: A retrospective study of 201 patients seen at the University of Pennsylvania - 19/06/20

Doi : 10.1016/j.jaad.2020.02.061 
Kimberly Bowerman, BS, MEd a, b, David R. Pearson, MD a, c, Joyce Okawa, RN a, c, Victoria P. Werth, MD a, c,
a Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania 
b Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania 
c Warren Alpert Medical School at Brown University, Providence, Rhode Island 

Reprint requests: Victoria P. Werth, MD, Department of Dermatology, Perelman Center for Advanced Medicine, Ste 1-330A, 3400 Civic Center Blvd, Philadelphia, PA 19104.Department of DermatologyPerelman Center for Advanced MedicineSte 1-330A3400 Civic Center BlvdPhiladelphiaPA19104

Abstract

Background

There is an increased incidence of malignancy in patients with dermatomyositis. It is unknown if the risk differs between the subtypes of dermatomyositis.

Objective

To (1) compare the prevalence of malignancy-associated dermatomyositis between patients with classic and clinically amyopathic disease and (2) determine factors associated with an increased risk of malignancy-associated disease.

Methods

Retrospective cohort study of 201 patients with adult-onset dermatomyositis prospectively enrolled in a longitudinal dermatomyositis database between July 2008 and April 2018 at an outpatient dermatology urban tertiary referral center. The main outcome measure was a diagnosis of malignancy, excluding nonmelanoma skin cancer.

Results

There were 201 patients with adult-onset dermatomyositis: 142 (71%) classic and 59 (29%) clinically amyopathic. Within 2 years of diagnosis, the prevalences of malignancy-associated classic and clinically amyopathic dermatomyositis were 9.9% and 1.7%, respectively. In this time period, patients who were older at dermatomyositis diagnosis (P = .01) and had the classic subtype (P = .04) were significantly more likely to have an underlying malignancy on multivariable regression analysis.

Limitations

This was a retrospective study of prospectively collected data at a single tertiary referral center.

Conclusion

Older age and classic dermatomyositis are independent risk factors for malignancy-associated dermatomyositis within 2 years of disease onset.

Le texte complet de cet article est disponible en PDF.

Key words : connective tissue disease, dermatomyositis, malignancy, medical dermatology, paraneoplastic

Abbreviations used : ANA, CADM, CDM, CI, DM, ETDM, IRB, MA, MA-CADM, MA-CDM, MA-DM, NXP-2, OR


Plan


 Funding sources: Supported by the US Department of Veterans Affairs (Veterans Health Administration, Office of Research and Development and Biomedical Laboratory Research and Development).
 Conflicts of interest: None disclosed.
 IRB approval status: Reviewed and approved by the University of Pennsylvania IRB (approval no. 829890).


© 2020  Publié par Elsevier Masson SAS.
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Vol 83 - N° 1

P. 117-122 - juillet 2020 Retour au numéro
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