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Dermatomiosite

Last reviewed: 14 Jul 2025
Last updated: 06 Apr 2018

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
Full details

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
Full details

Risk factors

  • predisposição genética
  • distribuição etária bimodal: crianças e idade >40 anos
  • sexo feminino
  • raça negra
  • radiação ultravioleta
  • agentes infecciosos
  • medicamentos
  • imunização
Full details

Diagnostic tests

1st tests to order

  • creatina quinase (CK) sérica
  • aldolase sérica
  • biópsia muscular
  • eletromiografia (EMG)
  • biópsia de pele
  • FAN
Full details

Tests 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
Full details

Treatment algorithm

ACUTE

doença grave ou agravamentos agudos

ONGOING

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
  • Dermatomiosite images
  • Differentials

    • Lúpus eritematoso cutâneo subagudo (LECS)
    • Psoríase
    • Linfoma cutâneo de células T
    More Differentials
  • Guidelines

    • 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
    More Guidelines
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