Dermatomyositis induced by drug therapy: a review of case reports

J Am Acad Dermatol. 2008 Nov;59(5):872-80. doi: 10.1016/j.jaad.2008.05.034. Epub 2008 Jul 14.

Abstract

Background: Drugs have occasionally been implicated in dermatomyositis (DM) onset.

Objective: We sought to review case reports of drug-induced DM.

Methods: Articles were gathered from MEDLINE and bibliographies of acquired reports. Causality was assessed using World Health Organization criteria. Clinical characteristics, management, and resolution were examined.

Results: In 70 reported cases, 50% of patients were female and the median age was 57 years. Hydroxyurea was implicated in 51% of cases. All cases had pathognomonic (76%) or compatible (24%) cutaneous findings. Hydroxyurea cases lacked myositis, but myositis was described in 79.4% of nonhydroxyurea cases. Drug causality was probable (25.7%) or possible (74.3%), but not certain in any case. Most patients had underlying pathology associated with DM (44% had malignancy; 16% had rheumatoid arthritis). Of the sample, 84.3% had improvement of DM after discontinuation of the drug.

Limitations: Case reports may emphasize unusual findings.

Conclusions: Further work is needed to differentiate drug effects from underlying, predisposing factors.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antinuclear / analysis
  • Autoimmune Diseases / drug therapy
  • Cyclophosphamide / adverse effects
  • Dermatomyositis / chemically induced*
  • Dermatomyositis / pathology
  • Etoposide / adverse effects
  • Female
  • Humans
  • Hydroxyurea / adverse effects
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Male
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Skin / pathology*

Substances

  • Antibodies, Antinuclear
  • Etoposide
  • Cyclophosphamide
  • Hydroxyurea