Talbott J H
Semin Arthritis Rheum. 1977 May;6(4):305-60. doi: 10.1016/0049-0172(77)90033-6.
A partial review of selected published case reports of AD-P associated with malignancy has been enhanced by the presentation of pertinent data on 15 unreported examples of the association. It is noteworthy that the first case in current literature of AD-P associated with a malignancy was described in 1916. The brief clinical report of a patient with proximal muscle weakness and skin lesions, with the obvious association with a malignancy (adenocarcinoma of the stomach), describes an example that has been repeated many times with different types of tumors but with essentially no variations in the clinical findings. In 1959 Williams identified 590 cases of AD with an overall tumor rate of 15%, and recently Barnes identified 258 cases of AD associated with a malignancy. The original designation, dermatomyositis or AD, has now been expanded to include proximal muscle polymyositis with systemic involvement, which syndrome at the current state of the art is indistinguishable clinically and pathologically from AD except for the lack of skin lesions. It may be that at some future time one or more immunologic features may differnetiate the clinical entity polymyositis from AD and further subdivide each of these entitites from similar clinical syndromes associated with a malignancy. However, the problem in management in either AD or polymyositis is similar. A number of patients with a malignancy and muscle weakness or neuropathy have been reported. These associations have been mentioned briefly, but insufficient data are available to determine whether these should be considered as a variant of AD-P or only casually related conditions with certain clinical features in common. Most of the patients described in the literature of AD-P with an associated malignancy have had skin lesions; a minority only have lacked this feature. However, unless a patient is followed carefully, it is possible for a transient or evanescent erythema or insignificant skin lesions to be present and not recorded in the case record.
通过展示15例未报告的皮肌炎-恶性肿瘤关联病例的相关数据，对已发表的皮肌炎-恶性肿瘤关联病例报告进行了部分回顾。值得注意的是，当前文献中首例皮肌炎-恶性肿瘤关联病例于1916年被描述。一份关于一名近端肌无力和皮肤病变患者的简短临床报告，明确显示其与恶性肿瘤（胃腺癌）有关联，这种病例已被多次报道，涉及不同类型的肿瘤，但临床表现基本无差异。1959年，威廉姆斯识别出590例皮肌炎病例，总体肿瘤发生率为15%，最近巴恩斯识别出258例与恶性肿瘤相关的皮肌炎病例。最初的命名，即皮肌炎或成人皮肌炎，现已扩展至包括伴有全身受累的近端肌多发性肌炎，就目前的技术水平而言，除了缺乏皮肤病变外，该综合征在临床和病理上与成人皮肌炎无法区分。也许在未来的某个时候，一种或多种免疫学特征可能会将临床实体多发性肌炎与成人皮肌炎区分开来，并进一步将这些实体与伴有恶性肿瘤的类似临床综合征区分开来。然而，成人皮肌炎或多发性肌炎的治疗问题是相似的。已有一些患有恶性肿瘤且伴有肌无力或神经病变的患者被报道。这些关联已被简要提及，但可用数据不足，无法确定这些应被视为皮肌炎-恶性肿瘤关联的变体，还是仅为具有某些共同临床特征的偶然相关病症。在皮肌炎-恶性肿瘤关联的文献中描述的大多数患者都有皮肤病变；少数患者仅缺乏这一特征。然而，除非对患者进行仔细随访，否则可能会出现短暂或一过性红斑或不明显的皮肤病变，且未记录在病例中。
