Santmyire-Rosenberger Beth, Dugan Elizabeth M
Departments of Dermatology, Washington Hospital Center, Washington, DC 20010, USA.
Curr Opin Rheumatol. 2003 Nov;15(6):714-22. doi: 10.1097/00002281-200311000-00006.
Dermatomyositis (DM) is a rare multisystem autoimmune disorder of adults and children that primarily affects skin and skeletal muscle. Classification systems of dermatomyositis, polymyositis, and the other idiopathic inflammatory myopathies focus primarily on features of muscle involvement. However, cutaneous disease does not always parallel muscle disease in its onset, activity, or response to therapy. This review will describe the distinct cutaneous clinical and histopathologic presentation of DM and the relation between these cutaneous findings, pathogenesis of DM, and serological subsets of DM.
This review discusses recent findings that have begun to elucidate the pathogenesis of DM, including polymorphism of tumor necrosis factor-alpha 308A allele and maternal fetal microchimerism. The recent description of other systemic diseases and drugs causing DM-like eruptions and the recognition that DM can resemble other common dermatoses highlights the need for a cutaneous biopsy to diagnose and distinguish the cutaneous features of DM. Once diagnosed, a number of noninvasive imaging modalities and new cutaneous assessment instruments can be used to follow and evaluate patients with DM.
Recognition of cutaneous and histopathologic findings in DM is essential for prompt and accurate diagnosis and treatment of DM.
皮肌炎（DM）是一种罕见的累及成人和儿童的多系统自身免疫性疾病，主要影响皮肤和骨骼肌。皮肌炎、多发性肌炎及其他特发性炎性肌病的分类系统主要关注肌肉受累的特征。然而，皮肤疾病在起病、活动或对治疗的反应方面并不总是与肌肉疾病平行。本综述将描述皮肌炎独特的皮肤临床和组织病理学表现，以及这些皮肤表现、皮肌炎发病机制和皮肌炎血清学亚组之间的关系。
本综述讨论了最近开始阐明皮肌炎发病机制的研究结果，包括肿瘤坏死因子-α 308A等位基因多态性和母胎微嵌合体。最近对其他导致皮肌炎样皮疹的全身性疾病和药物的描述，以及认识到皮肌炎可类似于其他常见皮肤病，凸显了进行皮肤活检以诊断和区分皮肌炎皮肤特征的必要性。一旦确诊，多种非侵入性成像方式和新的皮肤评估工具可用于随访和评估皮肌炎患者。
认识皮肌炎的皮肤和组织病理学表现对于皮肌炎的及时、准确诊断和治疗至关重要。
