Management of cutaneous dermatomyositis

Dermatomyositis (DM) is traditionally classified as an idiopathic inflammatory myopathy distinguished by muscle weakness and characteristic cutaneous findings. Patients presenting with the skin manifestations in the absence of clinical evidence of muscle weakness are categorized as clinically amyopathic DM. The symptoms associated with the cutaneous findings can be particularly debilitating, and a discordant response to therapy exists between muscle and skin disease. Various therapeutic agents and treatment approaches have been described, both for the cutaneous and extracutaneous manifestations; however, a paucity of controlled studies in this disease leads to limitations in interpreting the available data. In this review, emphasis is placed specifically on summarizing the current literature regarding management of cutaneous DM. In addition, an algorithmic approach to treatment of skin disease is presented.