Dermatomyositis: An Update on Diagnosis and Treatment

Am J Clin Dermatol. 2020 Jun;21(3):339-353. doi: 10.1007/s40257-020-00502-6.

Abstract

Dermatomyositis is a rare inflammatory disease with characteristic cutaneous findings and varying amounts of systemic involvement. Patients may present with skin disease alone, have concomitant muscle disease, or have extracutaneous manifestations such as pulmonary disease or an associated malignancy. Given such diverse presentations, dermatomyositis is both a diagnostic and therapeutic challenge. However, a prompt diagnosis is of utmost importance to institute adequate therapy and screen patients for an associated malignancy. Dermatologists should play a crucial role in the diagnosis and management of patients with dermatomyositis as cutaneous disease tends to be chronic, negatively impact quality of life, and be more recalcitrant to therapy. In this review, we discuss diagnosis, with a focus on myositis-specific antibodies and their associated phenotypes. We also review therapies available for this often refractory skin disease.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Administration, Intravenous
  • Administration, Oral
  • Antimalarials / administration & dosage
  • Antipruritics / administration & dosage
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Biopsy
  • Delayed Diagnosis / prevention & control
  • Dermatomyositis / blood
  • Dermatomyositis / diagnosis*
  • Dermatomyositis / immunology
  • Dermatomyositis / therapy*
  • Drug Therapy, Combination / methods
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunosuppressive Agents / administration & dosage
  • Muscle, Skeletal / immunology
  • Muscle, Skeletal / pathology
  • Protective Clothing
  • Quality of Life
  • Severity of Illness Index
  • Skin / immunology
  • Skin / pathology
  • Skin / radiation effects
  • Sunlight / adverse effects
  • Sunscreening Agents / administration & dosage
  • Treatment Outcome
  • Ultraviolet Rays / adverse effects

Substances

  • Antimalarials
  • Antipruritics
  • Autoantibodies
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Sunscreening Agents