Skip to main content

Advertisement

SpringerLink
Log in

Skin ulcer is a predictive and prognostic factor of acute or subacute interstitial lung disease in dermatomyositis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The aim of this study was to determine whether skin ulcer can be used as a predictive and prognostic factor of acute/subacute interstitial lung disease (ILD) in Japanese patients with dermatomyositis (DM). We reviewed the medical records of 39 consecutive DM patients who were admitted to Tokyo Metropolitan Komagome Hospital from January 2000 to December 2009. The mean follow-up period was 63.9 ± 51.6 months. Fifteen patients had acute/subacute ILD and 11 patients had chronic ILD. Seven out of 15 acute/subacute ILD led to respiratory failure and 3 of them died due to ILD. Skin ulcers were observed in 5 out of 15 patients with acute/subacute ILD (33.3 %) and in 2 out of 24 patients without acute/subacute ILD (8.3 %). The presence of skin ulcers was revealed to be a significant predictive factor for acute/subacute ILD among various parameters by multivariate analysis. In the 15 patients with acute/subacute ILD, the presence of skin ulcers was a significant poor prognostic factor (p = 0.0231) and the cumulative survival rate of patients with skin ulcers was 53.3 % for 12 months. Skin ulcer is a significant predictive and prognostic factor of acute/subacute ILD in patients with DM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Won Huh J, Soon Kim D, Keun Lee C, Yoo B, Bum Seo J, Kitaichi M et al (2007) Two distinct clinical types of interstitial lung disease associated with polymyositis-dermatomyositis. Respir Med 101(8):1761–1769

    Article  PubMed  Google Scholar 

  2. Kang EH, Lee EB, Shin KC, Im CH, Chung DH, Han SK et al (2005) Interstitial lung disease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis. Rheumatology (Oxford) 44(10):1282–1286

    Article  CAS  Google Scholar 

  3. Chen IJ, Jan Wu YJ, Lin CW, Fan KW, Luo SF, Ho HH et al (2009) Interstitial lung disease in polymyositis and dermatomyositis. Clin Rheumatol 28(6):639–646

    Article  PubMed  Google Scholar 

  4. Fathi M, Lundberg IE (2005) Interstitial lung disease in polymyositis and dermatomyositis. Curr Opin Rheumatol 17(6):701–706

    Article  PubMed  Google Scholar 

  5. Marie I, Hachulla E, Cherin P, Dominique S, Hatron PY, Hellot MF et al (2002) Interstitial lung disease in polymyositis and dermatomyositis. Arthritis Rheum 47(6):614–622

    Article  PubMed  CAS  Google Scholar 

  6. Gono T, Kawaguchi Y, Hara M, Masuda I, Katsumata Y, Shinozaki M et al (2010) Increased ferritin predicts development and severity of acute interstitial lung disease as a complication of dermatomyositis. Rheumatology (Oxford) 49(7):1354–1360

    Article  CAS  Google Scholar 

  7. Kameda H, Nagasawa H, Ogawa H, Sekiguchi N, Takei H, Tokuhira M et al (2005) Combination therapy with corticosteroids, cyclosporin A, and intravenous pulse cyclophosphamide for acute/subacute interstitial pneumonia in patients with dermatomyositis. J Rheumatol 32(9):1719–1726

    PubMed  CAS  Google Scholar 

  8. Ideura G, Hanaoka M, Koizumi T, Fujimoto K, Shimojima Y, Ishii W et al (2007) Interstitial lung disease associated with amyopathic dermatomyositis: review of 18 cases. Respir Med 101(7):1406–1411

    Article  PubMed  Google Scholar 

  9. Ye S, Chen XX, Lu XY, Wu MF, Deng Y, Huang WQ et al (2007) Adult clinically amyopathic dermatomyositis with rapid progressive interstitial lung disease: a retrospective cohort study. Clin Rheumatol 26(10):1647–1654

    Article  PubMed  Google Scholar 

  10. Mimori A, Suzuki T, Satoh N, Nara H, Masuyama J, Yoshio T et al (2000) Dermatomyositis and cutaneous necrosis: report of five cases. Mod Rheumatol 10:117–120

    Article  Google Scholar 

  11. Sato S, Hirakata M, Kuwana M, Suwa A, Inada S, Mimori T et al (2005) Autoantibodies to a 140-kd polypeptide, CADM-140, in Japanese patients with clinically amyopathic dermatomyositis. Arthritis Rheum 52(5):1571–1576

    Article  PubMed  CAS  Google Scholar 

  12. Nakashima R, Imura Y, Kobayashi S, Yukawa N, Yoshifuji H, Nojima T et al (2010) The RIG-I-like receptor IFIH1/MDA5 is a dermatomyositis-specific autoantigen identified by the anti-CADM-140 antibody. Rheumatology (Oxford) 49(3):433–440

    Article  CAS  Google Scholar 

  13. Gerami P, Schope JM, McDonald L, Walling HW, Sontheimer RD (2006) A systematic review of adult-onset clinically amyopathic dermatomyositis (dermatomyositis sine myositis): a missing link within the spectrum of the idiopathic inflammatory myopathies. J Am Acad Dermatol 54(4):597–613

    Article  PubMed  Google Scholar 

  14. American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med. 2000 Feb; 161(2 Pt 1):646–664

  15. Suda T, Fujisawa T, Enomoto N, Nakamura Y, Inui N, Naito T et al (2006) Interstitial lung diseases associated with amyopathic dermatomyositis. Eur Respir J 28(5):1005–1012

    Article  PubMed  CAS  Google Scholar 

  16. Cicuttini FM, Fraser KJ (1989) Recurrent pneumomediastinum in adult dermatomyositis. J Rheumatol 16(3):384–386

    PubMed  CAS  Google Scholar 

  17. Yosipovitch G, Feinmesser M, David M (1998) Adult dermatomyositis with livedo reticularis and multiple skin ulcers. J Eur Acad Dermatol Venereol 11(1):48–50

    Article  PubMed  CAS  Google Scholar 

  18. Jang KA, Kim SH, Choi JH, Sung KJ, Moon KC, Koh JK (1999) Subcutaneous emphysema with spontaneous pneumomediastinum and pneumothorax in adult dermatomyositis. J Dermatol 26(2):125–127

    PubMed  CAS  Google Scholar 

  19. Tsujimura S, Saito K, Tanaka Y (2008) Complete resolution of dermatomyositis with refractory cutaneous vasculitis by intravenous cyclophosphamide pulse therapy. Intern Med 47(21):1935–1940

    Article  PubMed  Google Scholar 

  20. Yamamoto T, Ohkubo H, Katayama I, Nishioka K (1994) Dermatomyositis with multiple skin ulcers showing vasculitis and membrano-cystic lesion. J Dermatol 21(9):687–689

    PubMed  CAS  Google Scholar 

  21. Scheinfeld NS (2006) Ulcerative paraneoplastic dermatomyositis secondary to metastatic breast cancer. Skinmed 5(2):94–96

    Article  PubMed  Google Scholar 

  22. Pusceddu V, Frau B, Guerzoni D, Catani G, Murgia M, Murru M et al (2008) Undescribed case of necrotic ulcerative amyopathic dermatomyositis in bone metastatic breast cancer. Breast J 14(6):591–592

    Article  PubMed  Google Scholar 

  23. Sigurgeirsson B, Lindelof B, Edhag O, Allander E (1992) Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N Engl J Med 326(6):363–367

    Article  PubMed  CAS  Google Scholar 

  24. Mukae H, Ishimoto H, Sakamoto N, Hara S, Kakugawa T, Nakayama S et al (2009) Clinical differences between interstitial lung disease associated with clinically amyopathic dermatomyositis and classic dermatomyositis. Chest 136(5):1341–1347

    Article  PubMed  Google Scholar 

  25. Kameda H, Takeuchi T (2006) Recent advances in the treatment of interstitial lung disease in patients with polymyositis/dermatomyositis. Endocr Metab Immune Disord Drug Targets 6(4):409–415

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors have declared no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, Japan

    Kazuyoshi Ishigaki, Junko Maruyama, Atsuko Murota, Yasunobu Takizawa & Keigo Setoguchi

  2. Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo, Bunkyo, Japan

    Kazuyoshi Ishigaki & Noboru Hagino

  3. Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Ran Nakashima & Tsuneyo Mimori

Authors
  1. Kazuyoshi Ishigaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Junko Maruyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Noboru Hagino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atsuko Murota
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yasunobu Takizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ran Nakashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tsuneyo Mimori
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Keigo Setoguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kazuyoshi Ishigaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ishigaki, K., Maruyama, J., Hagino, N. et al. Skin ulcer is a predictive and prognostic factor of acute or subacute interstitial lung disease in dermatomyositis. Rheumatol Int 33, 2381–2389 (2013). https://doi.org/10.1007/s00296-013-2735-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-013-2735-y

Keywords

Search

Navigation