METHODS: This retrospective study included 43 patients with CADM diagnosed at our institution from 2016 to 2020. Patients were subclassed into ADM (n = 30) and HDM (n = 13) groups to assess their clinicopathological differences.
RESULTS: All included patients had characteristic cutaneous manifestations of dermatomyositis; 67.4% had myositis-associated auto-antibodies, including ANA (32.6%), RNP (14.0%), anti-Ro52 (9.3%), anti-p155/140 (7.0%), rheumatoid factor (7.0%), anti-NXP-2 (4.7%), anti-MDA5 (2.3%), and anti-Jo-1 (2.3%) antibodies. One patient had associated interstitial lung disease, and another patient had oral squamous cell carcinoma. The histopathological findings included mucin deposition (69.8%), telangiectasia (65.1%), lymphocytic infiltrate (48.8%), vacuolar interface dermatitis (46.5%), and epidermal atrophy (14.0%). Compared to patients with HDM, ADM patients were significantly less likely to have epidermal atrophy, 3.3% versus 38.5% (p = 0.006), and more likely to have mucin deposition, 80.0% versus 46.2% (p = 0.028).
CONCLUSIONS: We described the clinicopathological features of CADM and highlighted the distinctions between ADM and HDM dermatopathologic findings. This information may prove helpful in diagnosing ambiguous lesions.
方法:这项回顾性研究包括2016年至2020年在我们机构诊断的43例CADM患者。将患者分为ADM(n=30)和HDM(n=13)组,以评估其临床病理差异。
结果:所有纳入的患者都有皮肌炎的特征性皮肤表现;67.4%有肌炎相关的自身抗体,包括ANA(32.6%),RNP(14.0%),反Ro52(9.3%),抗p155/140(7.0%),类风湿因子(7.0%),反恩智浦-2(4.7%),抗MDA5(2.3%),和抗Jo-1(2.3%)抗体。一名患者患有相关的间质性肺病,另一名患者患有口腔鳞状细胞癌。组织病理学发现包括粘蛋白沉积(69.8%),毛细血管扩张症(65.1%),淋巴细胞浸润(48.8%),空泡界面皮炎(46.5%),和表皮萎缩(14.0%)。与HDM患者相比,ADM患者出现表皮萎缩的可能性明显较小,3.3%对38.5%(p=0.006),更有可能有粘蛋白沉积,80.0%对46.2%(p=0.028)。
结论:我们描述了CADM的临床病理特征,并强调了ADM和HDM皮肤病理学发现之间的区别。这些信息可能有助于诊断模棱两可的病变。