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Lydia Cassard,1 Noelle Seraly,2 Maureen Riegert,3 Aditi Patel,4 Anthony P Fernandez5 1Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA; 2Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA; 3Department of Dermatology, Rush University, Chicago, IL, USA; 4Department of Rheumatology, Cleveland Clinic, Cleveland, OH, USA; 5Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, OH, USACorrespondence: Anthony P Fernandez, Departments of Dermatology and Pathology, Cleveland Clinic, 9500 Euclid Avenue; A61, Cleveland, OH, 44195, USA, Email fernana6@ccf.orgAbstract: Dermatomyositis is a heterogeneous idiopathic inflammatory myopathy associated with various cutaneous manifestations and variable presence of myositis, interstitial lung disease, and other visceral organ involvement. An accurate diagnosis of dermatomyositis requires correlating clinical examination findings with serological and histological findings. Familiarity with pathognomonic and common cutaneous manifestations of dermatomyositis, which are highlighted here, can be especially helpful in making an accurate diagnosis. Additionally, evaluating patients for presence of myositis-specific autoantibodies can further support or refute a dermatomyositis diagnosis. When present, myositis-specific autoantibodies can also help guide workups for various dermatomyositis-associated manifestations, as each is associated with relatively distinct clinical characteristics. Evaluating patients for various systemic manifestations often relies on expert opinion recommendations; however, societal guideline statements concerning the evaluation of some manifestations have recently been described. Although malignancy-associated dermatomyositis is a well-accepted subtype, there is limited evidence to support extensive malignancy screening has a favorable benefit–risk ratio in most dermatomyositis patients. However, recent research has uncovered novel associations between dermatomyositis and malignancy, suggesting the possibility of identifying high-risk subsets of dermatomyositis patients in whom malignancy screening may have a high value. Treatment for dermatomyositis has remained largely unchanged over the past several decades. Although many dermatomyositis patients can be effectively treated with current options, either as monotherapy or with combination regimens, there is a need for more targeted and effective DM therapies, in general, and for MDA5(+) dermatomyositis-associated rapidly progressive interstitial lung disease. Fortunately, significant current and emerging research activities evaluating various novel medications for dermatomyositis provide hope for exciting future advances in patients with this intriguing immune-mediated disease.Keywords: idiopathic inflammatory myopathy, myositis, autoantibody, malignancy, MDA-5, treatment |
