Distinctive cutaneous and systemic features associated with specific antimyositis antibodies in adults with dermatomyositis: a prospective multicentric study of 117 patients

J Eur Acad Dermatol Venereol. 2018 Jul;32(7):1164-1172. doi: 10.1111/jdv.14759. Epub 2018 Jan 31.

Abstract

Background: Identification of myositis-specific autoantibodies (MSAs) for dermatomyositis (DM) could allow the characterization of an antibody-associated clinical phenotype.

Objective: We sought to define the clinical phenotype of DM and the risk of cancer, interstitial lung disease (ILD) and calcinosis based on MSA.

Methods: A 3.5-year multicentre prospective study of adult DM patients was conducted to determine the clinical phenotype associated with MSAs and the presence of cancer, ILD and calcinosis.

Results: MSAs were detected in 47.1% of 117 included patients. Patients with antimelanoma differentiation-associated protein-5 antibodies (13.7%) had significantly more palmar violaceous macules/papules [odds ratio (OR) 9.9], mechanic's hands (OR 8), cutaneous necrosis (OR 3.2), articular involvement (OR 15.2) and a higher risk of ILD (OR 25.3). Patients with antitranscriptional intermediary factor-1 antibodies (11.1%), antinuclear matrix protein-2 antibodies (6.8%) and antiaminoacyl-transfer RNA synthetase (5.1%) had, respectively, significantly more poikiloderma (OR 5.9), calcinosis (OR 9.8) and articular involvement (OR 15.2). Cutaneous necrosis was the only clinical manifestation significantly associated with cancer (OR 3.1).

Conclusion: Recognition of the adult DM phenotype associated with MSAs would allow more accurate appraisal of the risk of cancer, ILD and calcinosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adenosine Triphosphatases / immunology
  • Adult
  • Aged
  • Aged, 80 and over
  • Amino Acyl-tRNA Synthetases / immunology
  • Antibodies / blood*
  • Calcinosis / blood
  • Calcinosis / complications
  • DNA-Binding Proteins / immunology
  • Dermatomyositis / blood*
  • Dermatomyositis / complications*
  • Female
  • Hand Dermatoses / blood
  • Hand Dermatoses / complications
  • Humans
  • Interferon-Induced Helicase, IFIH1 / immunology*
  • Joint Diseases / blood
  • Joint Diseases / complications
  • Lung Diseases, Interstitial / blood
  • Lung Diseases, Interstitial / complications
  • Male
  • Middle Aged
  • Necrosis
  • Neoplasms / complications*
  • Phenotype
  • Prospective Studies
  • Skin / pathology*
  • Transcription Factors / immunology
  • Young Adult

Substances

  • Antibodies
  • DNA-Binding Proteins
  • TRIM33 protein, human
  • Transcription Factors
  • Adenosine Triphosphatases
  • MORC3 protein, human
  • Interferon-Induced Helicase, IFIH1
  • Amino Acyl-tRNA Synthetases