Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- pápulas de Gottron
- rash heliotrópico cutâneo com ou sem edema periorbital
- eritema violáceo macular
- eritema periungueal, dilatação capilar da dobra ungueal, sobrecrescimento cuticular
- mãos de ”mecânico
- fraqueza muscular proximal
Other diagnostic factors
- fotossensibilidade
- poiquilodermia vascular atrofiante
- prurido
- fadiga e mal-estar
- dispneia
- perda de peso
- febre
- mialgia
- artralgia
- disfagia
- palpitações e síncope
- Fenômeno de Raynaud
- calcinose cutânea
- eritroderma
- lesões vesicobolhosas
- vasculite leucocitoclástica
- necrose cutânea
- alopecia não cicatricial
Risk factors
- predisposição genética
- distribuição etária bimodal: crianças e idade >40 anos
- sexo feminino
- raça negra
- radiação ultravioleta
- agentes infecciosos
- medicamentos
- imunização
Diagnostic investigations
1st investigations to order
- creatina quinase (CK) sérica
- aldolase sérica
- biópsia muscular
- eletromiografia (EMG)
- biópsia de pele
- FAN
Investigations to consider
- anticorpos específicos da miosite (AEMs)
- RNM muscular
- eletrocardiograma (ECG)
- ecocardiografia
- troponina cardíaca I
- radiografia torácica
- testes de função pulmonar (TFPs)
- tomografia computadorizada (TC) de alta resolução do tórax
- esofagografia baritada ou avaliação videofluoroscópica da deglutição
Treatment algorithm
doença grave ou agravamentos agudos
doença muscular e cutânea combinada
doença cutânea apenas
Contributors
Authors
Sarah A. Saunders, MRCP, MBChB
Consultant Physician and Rheumatologist
Department of Rheumatology
Centre for Rheumatic Diseases
Glasgow Royal Infirmary
Glasgow
UK
Disclosures
SAS declares that she has no competing interests.
Rajan Madhok, MD, FRCP(Glasg)
Consultant Physician and Rheumatologist
Department of Rheumatology
Glasgow Royal Infirmary
Glasgow
UK
Disclosures
RM holds shares in GSK to the value less than £12,000.
Acknowledgements
Dr Sarah A. Saunders and Dr Rajan Madhok would like to gratefully acknowledge Dr Nicola Alcorn, a previous contributor to this monograph. NA declares she has no competing interests.
Peer reviewers
Nizar Souayah, MD
Assistant Professor of Neurology
Director of EMG Laboratory & Peripheral Neuropathy Center
Department of Neurology & Neurosciences
New Jersey Medical School
Newark
NJ
Disclosures
NS declares that he has no competing interests.
Sami Khella, MD
Physician
Department of Neurology
Penn Presbyterian Medical Center
University of Pennsylvania Health System
Philadelphia
PA
Disclosures
SK declares that he has no competing interests.
Yusuf Yazici, MD
Assistant Professor
Associate Director
Arthritis Program
Director
Behcet's Syndrome Center
Seligman Center for Advanced Therapeutics
New York University Hospital for Joint Diseases
New York
NY
Disclosures
YY has served as a consultant for Bristol-Myers Squibb, Roche, Celgene, Centocor, and UCB, and has been a speaker for Pfizer and Bristol-Myers Squibb.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Drake LA, Dinehart SM, Farmer ER, et al; American Academy of Dermatology. Guidelines of care for dermatomyositis. J Am Acad Dermatol. 1996 May;34(5 Pt 1):824-9. Abstract
Bruschi F, Murrell KD. New aspects of human trichinellosis: the impact of new trichinella species. Postgrad Med J. 2002 Jan;78(915):15-22.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Lúpus eritematoso cutâneo subagudo (LECS)
- Psoríase
- Linfoma cutâneo de células T
More Differentials指南
- 2016 ACR/EULAR criteria for minimal, moderate, and major clinical response in adult dermatomyositis and polymyositis
- 2016 ACR/EULAR criteria for minimal, moderate, and major clinical response in juvenile dermatomyositis
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