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Amyopathic dermatomyositis: definitions, diagnosis, and management
Elizabeth E Bailey1, David F Fiorentino
1Department of Dermatology, Stanford University School of Medicine, 450 Broadway Drive, Redwood City, 94063, CA, USA.
Current Rheumatology Reports
|November 5, 2014
Summary
Clinically amyopathic dermatomyositis (CADM) presents without typical muscle symptoms but may involve subclinical muscle disease. CADM patients share comorbidities with classic dermatomyositis, indicating they are part of a disease spectrum.
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Amyopathic dermatomyositis diagnosis is difficult due to absent muscle findings.
- Clinically amyopathic dermatomyositis (CADM) involves subclinical muscle disease in a subset of patients.
- CADM patients represent a significant portion of dermatomyositis cases.
Purpose of the Study:
- To highlight the diagnostic challenges of amyopathic dermatomyositis.
- To emphasize the clinical significance of subclinical muscle disease in CADM.
- To advocate for recognizing CADM within the broader dermatomyositis spectrum.
Main Methods:
- Review of clinical presentations and diagnostic criteria for dermatomyositis subtypes.
- Analysis of comorbidities associated with CADM and classic dermatomyositis.
- Comparison of antibody profiles and disease associations between CADM and classic dermatomyositis.
Main Results:
- CADM patients exhibit subclinical muscle disease, complicating diagnosis.
- Comorbidities in CADM, including interstitial lung disease and malignancy, mirror those in classic dermatomyositis.
- Shared antibody subtypes suggest CADM and classic dermatomyositis are part of a common disease spectrum.
Conclusions:
- CADM should not be viewed as a separate entity from classic dermatomyositis.
- Early recognition of CADM is crucial for timely diagnosis and management.
- Understanding CADM's clinical presentation aids in managing associated comorbidities.
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