小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- Gottron 丘疹
- 向阳性皮疹，伴有或不伴有眶周水肿
- 紫红色斑片
- 甲周红斑，甲襞毛细血管扩张，角质层过度生长
- 技工手
- 近端肌肉无力
其他诊断因素
- 光敏感性
- 血管萎缩性皮肤异色症
- 瘙痒
- 乏力和不适感
- 呼吸困难
- 体重减轻
- 发热
- 肌痛
- 关节痛
- 吞咽困难
- 心悸和晕厥
- 雷诺现象
- 皮肤钙质沉着
- 红皮病
- 水疱大疱性损害
- 白细胞破碎性血管炎
- 皮肤坏死
- 非瘢痕性秃发
危险因素
- 遗传易感性
- 双峰年龄分布：儿童和年龄 ＞40 岁的成人
- 女性
- 黑人
- 紫外线辐射
- 感染性病原体
- 药物
- 免疫
诊断性检查
首要检查
- 血清肌酸激酶 (CK)
- 血清醛缩酶
- 肌肉活检
- 肌电图（EMG）
- 皮肤活检
- 抗核抗体 (ANA)
- 肌炎特异性抗体（myositis-specific antibody, MSA）和肌炎相关性抗体（myositis-associated antibody, MAA）
需考虑的检查
- 肌肉 MRI
- 心电图 (ECG)
- 超声心动图
- 心脏肌钙蛋白I
- 胸部 X 线检查 (CXR)
- 肺功能检查 (PFT)
- 高分辨率胸部 CT 扫描
- 钡餐或吞钡透视
治疗流程
严重疾病或急性发作
有肌肉和皮肤疾病
仅有皮损
撰稿人
作者
Michael Edward Farrugia, MD, PgDip, MRCP (Derm)
Dermatology Specialty Trainee
Lauriston Building
NHS Lothian
Edinburgh
UK
利益声明
MEF declares that he has no competing interests.
Meng May Chee, MBChB, MD, MRCP
Consultant Rheumatologist
Queen Elizabeth University Hospital
Glasgow
UK
利益声明
MMC accepted a sponsored invitation to attend the EULAR e-congress in June 2020.
Girish Gupta, FRCP
Consultant Dermatologist
Lauriston Building
Edinburgh
UK
利益声明
GG has received honoraria for membership of advisory boards from Almirall, Leo, Lilly, Mylan, and Novartis. GG has also received lecture fees from AbbVie, Almirall, Galderma, La Roche Posay, Leo, Mylan, and Novartis. GG declares that none of the payments are related to this topic or treatments discussed in this topic, and there are no contractual agreements to disseminate product information.
鸣谢
Dr Michael E. Farrugia, Dr Meng May Chee, and Dr Girish Gupta would like to gratefully acknowledge Dr Sarah A. Saunders, Dr Rajan Madhok, and Dr Nicola Alcorn, previous contributors to this topic.
利益声明
SAS and NA declare that they have no competing interests. RM declared holding shares in GSK to the value less than £12,000.
同行评议者
Nizar Souayah, MD
Assistant Professor of Neurology
Director of EMG Laboratory & Peripheral Neuropathy Center
Department of Neurology & Neurosciences
New Jersey Medical School
Newark
NJ
利益声明
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
利益声明
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
利益声明
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.
鉴别诊断
- 亚急性皮肤红斑狼疮
- 银屑病
- 皮肤 T 细胞淋巴瘤
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