Clinical analysis for 108 cases of dermatomyositis / 中南大学学报(医学版)

ABSTRACT

To investigate the clinical characteristics of dermatomyositis, to investigate the types and clinical features of dermatomyositis complicated with malignant tumor, and to provide evidence for clinical diagnosis, treatment and prognostic evaluation.
 Methods: The clinical manifestations and laboratory test results for 108 cases of dermatomyositis with complications in the Second Xiangya Hospital of Central South University were analyzed.
 Results: Patients aged from 14 to 60 years accounted for 62.96%. The first symptom was single skin rash (54.63%), and the most characteristic cutaneous features were asymmetrical proximal myositis with various degrees (97.22%). The visceral involvement was as follows the digestive tract (31.48%), the heart (19.44%), the lung (26.85%), and the thyroid damage (12.96%). Twelve (11.11%) patients were combined with malignant tumor. The positive rates for albumin (ALB), glutamic oxalacetic transaminase (AST), glutamic-pyruvic transaminase (ALT), lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), erythrocyte sedimentation rate (ESR), anti Jo-1 antibody, anti ribonucleoprotein (RNP) antibody, and anti-topoisomerasel (Scl) antibody were 25.93%, 46.30%, 28.70%, 87.04%%, 51.85%, 26.85%, 55.56%, 2.27%, 8.99%, and 2.27%, respectively. The patients were divided into a tumor group and a non-tumor group. The chi-square test results from clinical symptoms and laboratory tests suggested that increase of ESR was a risk factor for dermatomyositis combining tumor. The main strategy of therapy was corticosteroids.
 Conclusion: Dermatomyositis possesses typical skin lesions and dermatitis is the most common initial symptom of dermatomyositis. In clinic, diagnosis of dermatomyositis should be timely combined with muscle enzymes test, electromyography and muscle biopsy. Dermatomyositis can easily involve many organs. Thus relevant examinations (such as chest X-ray and CT) should be done preventively. Rapid ESR is a risk factor for dermatomyositis complicated with malignant tumor and it can be used as an index to guide clinical diagnosis.