4.6 Article

Diagnosing muscle disease in a cohort of classic dermatomyositis patients seen at a rheumatologic dermatology outpatient clinic

Journal

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Volume 86, Issue 3, Pages 544-550

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2021.05.026

Keywords

autoimmune disease; cost efficacy; dermatomyositis; diagnosis; myositis; practice; rheumatologic dermatology

Categories

Funding

  1. National Institutes of Health [R21 AR066286]
  2. Veterans Affairs Merit Review [I01BX000706]

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This study aimed to investigate the effectiveness of less invasive diagnostic procedures for diagnosing dermatomyositis (DM). The results showed that in the presence of DM-specific skin findings, less invasive procedures may be sufficient for diagnosing DM.
Background: Existing criteria to improve the probability of capturing dermatomyositis (DM) include muscle biopsy but little is known about whether less invasive diagnostic procedures may be just as useful. Objective: We aimed to determine whether skin biopsy, electromyography, or magnetic resonance imaging of the involved muscle could be done in lieu of muscle biopsy. Methods: Two hundred and seventy-five patients were reviewed to investigate the presence of cutaneous and muscle disease, their timing in relation to diagnosis, and results of skin biopsies, muscle biopsies, magnetic resonance imaging, and electromyography. Results: Of the cases with findings consistent with DM on muscle biopsy, 65% were in agreement with diagnostic features on electromyography or magnetic resonance imaging. Results of skin and muscle biopsies supported DM in 67% of patients who underwent both procedures. Limitations: A limited number of patients had muscle biopsies. Conclusion: In the presence of DM-specific skin findings, less invasive procedures may be sufficient to diagnose DM and guide its management.

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