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Dermatomyositis with panniculitis.

Sueli Carneiro1, Giselle Alvim, Patricia Resende

  • 1Section of Dermatology, Federal University of Rio de Janeiro, School of Medicine, HUCFF, Rio de Janeiro, Brazil. sueli@hucff.ufrj.br

Skinmed
|January 12, 2007
PubMed
Summary
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This study highlights two cases of dermatomyositis presenting with subcutaneous nodules, a rare manifestation. These nodules showed lobular panniculitis and fat necrosis, suggesting a distinct pathological feature in this autoimmune disease.

Area of Science:

  • Rheumatology
  • Dermatology
  • Pathology

Background:

  • Dermatomyositis is an idiopathic inflammatory myopathy characterized by characteristic skin and muscle involvement.
  • Subcutaneous nodules are an uncommon finding in dermatomyositis, with varying histopathological descriptions.

Observation:

  • Two cases of dermatomyositis are presented, both with erythematous violaceous rashes, muscle involvement, and the later development of deep asymptomatic subcutaneous nodules.
  • Histopathology of the nodules revealed lobular panniculitis with inflammatory infiltrate, fat necrosis, and in one case, calcium deposition, without evidence of vasculitis.

Findings:

  • The clinical and laboratory findings in both cases were consistent with dermatomyositis, including elevated muscle enzymes and positive antinuclear antibodies.
  • The histopathological findings of subcutaneous nodules in these cases suggest a specific pattern of panniculitis associated with dermatomyositis.

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Implications:

  • The presence of subcutaneous nodules in dermatomyositis may represent a distinct clinical-pathological subset.
  • Further research is warranted to understand the pathogenesis and clinical significance of these nodules in dermatomyositis.