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Complete resolution of dermatomyositis with refractory cutaneous vasculitis by intravenous cyclophosphamide pulse
Shizuyo Tsujimura1, Kazuyoshi Saito, Yoshiya Tanaka
1The First Department of Internal Medicine, University of Occupational & Environmental Health, School of Medicine, Kitakyushu.
Abstract:
Cutaneous ulcers associated with vasculitis are rarely reported in adult-onset dermatomyositis (DM), and are often resistant to treatment, resulting in a poor prognosis. There is no general treatment strategy and the effects of various treatments have never been confirmed histopathologically. A 43-year old man with DM developed refractory multiple cutaneous ulcers which were revealed as vasculitis by skin biopsy. Repeated intravenous cyclophosphamide pulse therapy (IV-CY) without high-dose corticosteroid therapy resulted in complete resolution of the ulcers without adverse effects or severe complications. A repeat biopsy confirmed complete remission of vasculitis. Repeated IV-CY is a useful treatment for induction of clinical remission of DM with cutaneous vasculitis.
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