Although dermatomyositis is a rare disorder, it is of interest to different medical specialists such as rheumatologists, pediatricians, dermatologists, neurologists, and general practitioners, because of the diversity of clinical syndromes, the difficulties in diagnosis and therapeutic management, and the severe prognosis. The interdisciplinary disposition also complicates the diagnostic approach.
Sometimes the patient endures the long journey from one physician to another, and exact diagnosis takes a long period of time. The patient’s saga becomes even more complicated following the definition of amyopathic dermatomyositis and drug-induced skin eruption resembling dermatomyositis. The author is one of the first clinicians who coined the possibility of the existence of “drug-induced dermatomyositis”. It is true that dermatomyositis is difficult to diagnose if the physician does not expect it, or misdiagnoses it for another disease of connective tissue, for example lupus erythematosus, or even disregards its existence.
This advanced monograph gives a description of the clinical symptoms of dermatomyositis and a methodology for diagnosis preparation, as well as new diagnostic immunological and photobiological methods and treatment modalities. The authors have personal experience with diagnoses, treatment, and management control of many dermatomyositis patients.
1 Introduction
2 History of Dermatomyositis
3 Classification of Dermatomyositis
4 Diagnostic Criteria
- 4.1 Helpful Hints
- 4.2 Myositis Diagnostic Tests
- 4.3 Cutaneous Diagnostic Criteria
- 4.4 Cutaneous Disease Indexes
- 4.5 Cutaneous Laboratory Tests
- 4.6 Markers for Inflammatory Disease
- 5.1 Age
- 5.2 Gender
- 5.3 Race
- 5.4 Ethnicity
- 5.5 Familial DM
- 5.6 HLA
- 5.7 Seasons and Climate
- 5.8 Latitude
- 5.9 Evolution
- 5.10 Clinical Variants
Clinical Manifestations of Dermatomyositis
6 Cutaneous Manifestations of Dermatomyositis
7 Oral Manifestations of Dermatomyositis
8 Musculoskeletal Involvement in Dermatomyositis
9 Joint Involvement
10 Cardiac Manifestations of Dermatomyositis
Complications of Dermatomyositis
11 Pulmonary Complications of Dermatomyositis
12 Gastroinestinal Complications of Dermatomyositis
13 Ophthalmic Complications of Dermatomyositis
14 Renal Complications of Dermatomyositis
15 Complications of Central Nervous System in Dermatomyositis
16 Pregnancy Complicated by Dermatomyositis
17 Calcinosis in Dermatomyositis
18 Internal Malignancy Associated with Dermatomyositis
- 18.1 Population-Based Epidemiologic Studies
- 18.2 Is DM a Paraneoplastic Phenomenon?
- 18.3 Age
- 18.4 Temporal Relationship between Dermatomyositis and Malignancy
- 18.5 Tumor Types of Occult Malignancy in DM
- 18.6 Malignancy in Different Clinical Variants of DM
- 18.7 Regional Association
Clinical Variants of Dermatomyositis
19 Classic Dermatomyositis in Adults
- 19.1 Association of DM with Other Dermatoses
- 19.2 Muscle Disease in DM
- 19.3 Autoantibody Defined Syndromes in DM
- 19.3.1 Anti-Mi-2 Antibody Syndrome
- 19.3.2 Antisynthetase Syndrome [Anti-Jo-1 Antibody Syndrome]
- 19.3.3 Anti-Signal Recognition Particle Syndrome [Anti-SRP Syndrome]
- 19.3.4 Association of DM with Internal Diseases
- 21 Amyopathic Dermatomyositis
- 22 Paraneoplastic Dermatomyositis
- 23 Overlap Syndromes
- 24 Drug-Induced Dermatomyositis
Other Idiopathic Inflammatory Myopathies
25 Polymyositis
- 25.1 Autoantibody Defined Syndromes in PM/DM
- 25.1.1 Antisynthetase Syndromes [Anti-Jo-1 Antibody Syndrome]
- 25.1.2 Anti-Signal Recognition Particle Syndrome [Anti-SRP Syndrome]
27 Orbital Myositis
28 Eosinophilic Myositis/Perimyositis
29 Eosinophilia–Myalgia Syndrome and Eosinophilic Fasciitis (Shulman Syndrome)
Laboratory Manifestations of Dermatomyositis
30 Muscle Enzymes
31 Autoantibodies
- 31.1 Myositis-Specific Autoantibodies
- 31.2 Myositis-Associated Autoantibodies
- 32.1 Instrumental Assessments of Disease Activity in Myositis
- 32.1.1 Electromyography
- 32.1.2 Magnetic Resonance Imaging
- 32.1.3 Magnetic Resonance Spectroscopy (MRS)
- 32.1.4 Proton Magnetic Resonance Spectroscopy
- 32.1.5 Ultrasound
- 32.1.6 Anti-Myosin Scintigraphy
- 32.1.7 Functional Assessment
- 32.2 Instrumental Assessments of Cutaneous Disease Activity of DM
- 32.2.1 Nailfold Capillary Microscopy
- 32.2.2 Photosensitivity in Dermatomyositis
- 32.2.3 Skin Assessment Instruments
- 33.1 Histopathology and Immunopathology of Myositis in DM Patients
- 33.2 Histopathology and Immunopathology of Skin Lesions in DM
Diagnosis and Differential Diagnosis of DM
34 Medical Evolution of Dermatomyositis
35 Differential Diagnosis of Dermatomyositis
Etiology and Pathogenesis
36 Etiology of Dermatomyositis
- 36.1 Environmental Factors
- 36.2 Infectious Agents
- 37.1 Genetic Data
- 37.2 The HLA-DQA1*0501 Allele
- 37.3 Gene Expression Profiling
- 37.4 The TNF-a-308A Allele
- 37.5 The Role of Complement
- 37.6 The Role of Cytokines
- 37.7 Soluble Adhesion Molecules
39 Pharmacologic Agents in the Treatment of DM:
- 39.1 Corticosteroids
- 39.2 Immunosuppressive and Steroid-Sparing Drugs
- 39.2.1 Methotrexate
- 39.2.2 Azathioprine
- 39.2.3 Cyclosporine A
- 39.2.4 Cyclophosphamide
- 39.2.5 Micophenolate Mofetil
- 39.2.6 Chlorambucil
- 39.2.7 Mercaptopurine
- 39.2.8 Fludarabine
- 39.2.9 Aminoquinolone Antimalarials
- 39.3 Immunobiologic (Immunomodulating) Therapy
- 39.3.1 Intravenous Immunoglobulins
- 39.3.2 Anticytokines: Infliximab | Etanercept | Tacrolimus | Eculizumab | Rituximab
- 39.3.3 Thalidomide
- 39.3.4 Dapsone
- 39.4 Combination of Regimes
- 40.1 Therapy of Cutaneous Manifestations
- 40.2 Treatment of Pulmonary Disease
- 40.3 Treatment of Calcinosis
- 40.4 Treatment of Dermatomyositis in Pregnant Women
- 40.5 Treatment of Paraneoplastic Dermatomyositis
- 41.1 Plasmapheresis (Plasma Exchange)
- 41.2 Extracorporeal Photochemotherapy
- 41.3 Total-Body Irradiation
- 41.4 Thymectomy
- 41.5 Transplantation of Autologous Stem Cells
- 41.6 Physical Therapies and Rehabilitation of Dermatomyositis
- 41.7 Diet
- 41.8 Prevention
42 Evolution and Prognosis of Dermatomyositis
Book Details
- Hardcover: 354 pages
- Publisher: Springer; 1 edition (May 11, 2009)
- Language: English
- ISBN-10: 3540793127
- ISBN-13: 978-3540793120
- Product Dimensions: 9.4 x 6.3 x 0.8 inches