Document Detail

Interstitial lung disease in classic and skin-predominant dermatomyositis: a retrospective study with screening recommendations.
MedLine Citation:
PMID:  20644033     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: (1) To determine the prevalence of interstitial lung disease (ILD) and isolated low diffusing capacity for carbon monoxide (DLCO) in a large cohort of outpatients with dermatomyositis. (2) To compare the pulmonary abnormalities of patients with classic dermatomyositis and those with skin-predominant dermatomyositis.
DESIGN: Retrospective cohort study.
SETTING: University hospital outpatient dermatology referral center. Patients Medical records of 91 outpatients with adult-onset dermatomyositis seen between May 26, 2006, and May 25, 2009, were reviewed.
MAIN OUTCOME MEASURES: Presence of ILD on thin-slice chest computed tomographic (CT) scans and DLCO.
RESULTS: Of the 71 patients with dermatomyositis who had CT or DLCO data, 16 (23%; 95% confidence interval [CI], 13%-33%) had ILD as defined by CT results [corrected]. All patients with ILD had a reduced DLCO, and the ILD prevalence was not different between patients with skin-predominant dermatomyositis (10 of 35 [29% ]) and those with classic dermatomyositis (6 of 36 [17% ]) (P = .27). Eighteen of 71 patients with dermatomyositis (25%; 95% CI, 15%-36%) (7 of 35 [20%] with skin-predominant dermatomyositis; 11 of 36 [31%] with classic dermatomyositis; P = .41) had a low DLCO in the absence of CT findings showing ILD. The prevalence of malignant disease was higher in patients with classic dermatomyositis than in those with skin-predominant dermatomyositis (P = .02), and no patients with skin-predominant dermatomyositis had internal malignant disease.
CONCLUSIONS: Radiologic ILD and isolated DLCO reductions, which may signify early ILD or pulmonary hypertension, are common in dermatology outpatients with both classic and skin-predominant dermatomyositis. Because DLCO testing is both inexpensive and sensitive for pulmonary disease, it may be appropriate to screen all patients with dermatomyositis with serial DLCO measurements and base further testing on DLCO results.
Pamela A Morganroth; Mary Elizabeth Kreider; Joyce Okawa; Lynne Taylor; Victoria P Werth
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of dermatology     Volume:  146     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-09-21     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  729-38     Citation Subset:  AIM; IM    
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MeSH Terms
Dermatomyositis / complications,  diagnosis,  epidemiology*
Follow-Up Studies
Lung Diseases, Interstitial / complications,  diagnosis,  epidemiology*
Mass Screening / standards*
Middle Aged
Practice Guidelines as Topic*
Pulmonary Diffusing Capacity
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed
Grant Support
5T32-AR007465-26/AR/NIAMS NIH HHS; K24 AR002207/AR/NIAMS NIH HHS; K24 AR002207-07/AR/NIAMS NIH HHS; K24-AR 02207/AR/NIAMS NIH HHS
Erratum In:
Arch Dermatol. 2010 Oct;146(10):1197

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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