Dermatomyositis: Diagnosis and treatment - 09/01/20

Doi : 10.1016/j.jaad.2019.05.105

Reid Waldman, MD ^a, Madeline E. DeWane, BA ^b, Jun Lu, MD ^a,^⁎
^a Department of Dermatology, University of Connecticut, Farmington, Connecticut
^b University of Connecticut, School of Medicine, Farmington, Connecticut

^∗Reprint requests: Jun Lu, MD, Department of Dermatology, University of Connecticut, 21 South Rd, Farmington, CT 06032.Department of DermatologyUniversity of Connecticut21 South RdFarmingtonCT06032

Abstract

The second article in this continuing medical education series reviews the initial evaluation of patients with suspected dermatomyositis (DM), the relevant work-up for malignancy and interstitial lung disease once a diagnosis of DM is made, and treatment recommendations for patients with DM based on disease severity, the presence of systemic symptoms, and myositis-specific antibody (MSA) profiles. This review emphasizes the emerging role of MSAs in the diagnosis of DM and highlights how MSAs can be used to guide the appropriate work-up for malignancy and interstitial lung disease. The treatment approach proposed by this continuing medical education series discusses both established and novel therapies for DM and highlights the importance of considering lesion type, degree of muscle involvement, presence of systemic symptoms, presence of MSAs, and patient age when determining the best treatment approach for a patient with DM.

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Key words : anti-MDA5 dermatomyositis, cancer-associated dermatomyositis, dermatomyositis, juvenile dermatomyositis

Abbreviations used : EULAR/ACR, ILD, IVIG, JDM, JKI, MMF, MSA, MTX, RP-ILD