Complete resolution of dermatomyositis with refractory cutaneous vasculitis by intravenous cyclophosphamide pulse therapy

Intern Med. 2008;47(21):1935-40. doi: 10.2169/internalmedicine.47.1289. Epub 2008 Nov 4.

Abstract

Cutaneous ulcers associated with vasculitis are rarely reported in adult-onset dermatomyositis (DM), and are often resistant to treatment, resulting in a poor prognosis. There is no general treatment strategy and the effects of various treatments have never been confirmed histopathologically. A 43-year old man with DM developed refractory multiple cutaneous ulcers which were revealed as vasculitis by skin biopsy. Repeated intravenous cyclophosphamide pulse therapy (IV-CY) without high-dose corticosteroid therapy resulted in complete resolution of the ulcers without adverse effects or severe complications. A repeat biopsy confirmed complete remission of vasculitis. Repeated IV-CY is a useful treatment for induction of clinical remission of DM with cutaneous vasculitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cyclophosphamide / administration & dosage*
  • Dermatomyositis / complications
  • Dermatomyositis / diagnosis
  • Dermatomyositis / drug therapy*
  • Humans
  • Infusions, Intravenous
  • Male
  • Pulse Therapy, Drug
  • Remission Induction
  • Vasculitis / complications
  • Vasculitis / diagnosis
  • Vasculitis / drug therapy*

Substances

  • Cyclophosphamide