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1.
J Cutan Pathol ; 49(5): 442-447, 2022 May.
Article in English | MEDLINE | ID: mdl-35080246

ABSTRACT

BACKGROUND: Understanding whether specific histopathologic features on skin biopsy are predictive of systemic associations in dermatomyositis (DM) would be useful to guide clinical screening. METHODS: Through retrospective medical record search, clinical and laboratory findings of patients with DM were documented. Existing skin biopsy slides were re-reviewed blindly. RESULTS: Of all biopsy specimens (n = 42), the most frequent histopathological finding was vacuolar interface dermatitis (95%). Other features included perivascular lymphocytic infiltrate (71%), increased dermal mucin (40%), vessel wall thickening (12%), follicular plugging (9.5%), and dermal sclerosis (7%). Neutrophilic infiltrate was observed in three biopsies from a patient with adalimumab-associated DM. Vasculitis was not observed. There was no statistically significant difference in the presence of any histopathological feature and that of various systemic manifestations (i.e., myopathy, interstitial lung disease [ILD] and malignancy). However, we observed that dense lichenoid infiltrate rather than pauci-inflammatory changes correlated with severe itching (p < 0.001). Patients with MDA-5 antibodies were significantly more likely to have vasculopathy than those without (p = 0.029*). CONCLUSIONS: No dermatopathologic feature was reliably predictive of myopathy, ILD, or malignancy. This finding implies that, regardless of histopathologic findings, patients should be screened for associated conditions as clinically indicated.


Subject(s)
Dermatomyositis , Lung Diseases, Interstitial , Neoplasms , Biopsy , Dermatomyositis/pathology , Humans , Retrospective Studies
2.
Hum Pathol ; 91: 86-113, 2019 09.
Article in English | MEDLINE | ID: mdl-31278974

ABSTRACT

Not uncommonly, pathologists encounter biopsies displaying inflammation at the dermoepidermal junction and confronted with its numerous diagnostic possibilities. As with other inflammatory dermatoses, the correct diagnosis relies on careful integration of clinical, laboratory, and histopathological features. Knowledge of clinical aspects of these disorders is crucial, and at times, lack of training in clinical dermatology can make clinicopathological correlation challenging for the pathologist. This review is organized following the classical classification of cell-poor (vacuolar) and cell-rich (lichenoid) interface processes. The various entities are described based on their clinical presentation along their clinical differential diagnosis followed by their histopathological features and pathological differential diagnosis. Our aim is to provide an updated, clinically relevant review that integrates nuanced clinical and pathological features, with an emphasis on clues that may help differentiate entities in the differential diagnosis.


Subject(s)
Dermatitis/diagnosis , Dermatitis/pathology , Humans , Inflammation/diagnosis , Inflammation/pathology , Skin/pathology
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