Dermatomyositis in women: a 15-year retrospective analysis of clinical patterns, malignancy risk, and long-term outcomes at a tertiary center

Acta Dermatovenerol Alp Pannonica Adriat. 2025 Dec;34(4):165-169.

Abstract

Introduction: Dermatomyositis is an inflammatory disease that affects the skin and skeletal muscles, with variants including clinically amyopathic dermatomyositis and malignancy-associated dermatomyositis.

Methods: This research analyzes the characteristics of dermatomyositis in women. A retrospective cross-sectional study evaluated clinical presentation, muscle involvement, immunological markers, association with malignancy, complications, and mortality in females during a 15-year follow-up at a tertiary dermatology center.

Results: Thirty women (mean age 63.6 ± 11.6 years) were analyzed. The most common skin manifestations were the V-sign (73.3%), followed by a heliotrope rash and Gottron's papules (70.0% each). Periungual erythema appeared in 50.0%, and the shawl sign in 46.7%. Receiver operating characteristic curve analysis linked the V-sign with age ≥ 62.5 years (area under the curve = 0.75) and periungual erythema with age ≤ 68.5 (area under the curve = 0.76). Muscle weakness was present in 63.3% of cases. Myositis-associated autoantibodies and myositis-specific autoantibodies were positive in 53.3%. Seven patients (23.3%) had malignancy-associated dermatomyositis, including ovarian, breast, endometrial, lung, gastric, and nasopharyngeal cancers.

Conclusions: The V-sign, a heliotrope rash, and Gottron's papules were the most common skin findings. Muscle involvement affected nearly two-thirds of patients. Malignancy was detected in almost a quarter of patients, emphasizing the need for thorough evaluation and early diagnosis, especially in cancer-associated cases.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Dermatomyositis* / complications
  • Dermatomyositis* / diagnosis
  • Dermatomyositis* / epidemiology
  • Female
  • Humans
  • Middle Aged
  • Neoplasms* / complications
  • Neoplasms* / epidemiology
  • Retrospective Studies
  • Tertiary Care Centers