药物治疗引起的皮肌炎：病例报告综述

Dermatomyositis induced by drug therapy: a review of case reports.

作者信息

Seidler Anne M, Gottlieb Alice B

机构信息

Department of Dermatology, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts 02111-1533, USA.

出版信息

J Am Acad Dermatol. 2008 Nov;59(5):872-80. doi: 10.1016/j.jaad.2008.05.034. Epub 2008 Jul 14.

DOI:10.1016/j.jaad.2008.05.034

PMID:18625537

Abstract

BACKGROUND

Drugs have occasionally been implicated in dermatomyositis (DM) onset.

OBJECTIVE

We sought to review case reports of drug-induced DM.

METHODS

Articles were gathered from MEDLINE and bibliographies of acquired reports. Causality was assessed using World Health Organization criteria. Clinical characteristics, management, and resolution were examined.

RESULTS

In 70 reported cases, 50% of patients were female and the median age was 57 years. Hydroxyurea was implicated in 51% of cases. All cases had pathognomonic (76%) or compatible (24%) cutaneous findings. Hydroxyurea cases lacked myositis, but myositis was described in 79.4% of nonhydroxyurea cases. Drug causality was probable (25.7%) or possible (74.3%), but not certain in any case. Most patients had underlying pathology associated with DM (44% had malignancy; 16% had rheumatoid arthritis). Of the sample, 84.3% had improvement of DM after discontinuation of the drug.

LIMITATIONS

Case reports may emphasize unusual findings.

CONCLUSIONS

Further work is needed to differentiate drug effects from underlying, predisposing factors.

摘要

背景

药物偶尔会被认为与皮肌炎（DM）的发病有关。

目的

我们试图回顾药物性DM的病例报告。

方法

从MEDLINE及已发表报告的参考文献中收集文章。使用世界卫生组织标准评估因果关系。对临床特征、治疗及病情缓解情况进行研究。

结果

在70例报告病例中，50%为女性，中位年龄为57岁。51%的病例与羟基脲有关。所有病例均有特征性（76%）或相符（24%）的皮肤表现。羟基脲相关病例无肌炎表现，但79.4%的非羟基脲相关病例有肌炎描述。药物因果关系很可能（25.7%）或有可能（74.3%），但在任何病例中均未确定。大多数患者有与DM相关的基础病变（44%有恶性肿瘤；16%有类风湿关节炎）。在样本中，84.3%患者在停药后DM病情改善。