Schmid M H, Trüeb R M
Department of Dermatology, University Hospital of Zürich, Switzerland.
Br J Dermatol. 1997 Mar;136(3):431-3.
We report a 15-year-old girl with a 10-year-old history of typical skin features of dermatomyositis (DM) without evidence of muscle involvement. Amyopathic dermatomyositis (ADM) is defined by the presence of biopsy confirmed classic cutaneous findings of dermatomyositis in the absence of any clinical or laboratory signs of muscle disease for at least 2 years after onset of skin pathology. To exclude muscle involvement muscle enzymes should be normal; moreover additional use of magnetic resonance imaging and muscle ultrasound is currently being proposed. It is as yet undetermined, whether early aggressive immunosuppressive treatment of ADM might prevent the development of myositis at a later date or influence the course of the skin disease. In a paediatric patient with ADM we advocate a more expectant attitude with careful and regular monitoring for possible development of muscle disease.
我们报告了一名15岁女孩，有10年皮肌炎（DM）典型皮肤特征病史，但无肌肉受累证据。无肌病性皮肌炎（ADM）的定义为，在皮肤病理出现后至少2年，活检证实有皮肌炎典型皮肤表现，且无任何肌肉疾病的临床或实验室征象。为排除肌肉受累，肌肉酶应正常；此外，目前有人提议额外使用磁共振成像和肌肉超声检查。ADM早期积极免疫抑制治疗是否能预防后期肌炎的发生或影响皮肤病病程，目前尚不确定。对于患有ADM的儿科患者，我们主张采取更保守的态度，仔细定期监测是否可能发生肌肉疾病。
