Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial Symptom
Panniculitis is an uncommon skin eruption observed in patients with dermatomyositis (DM)/clinically amyopathic dermatomyositis (CADM), especially in anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive DM. We present here a 51-year-old Japanese woman with an anti-MDA5 antibody-po...
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doaj-6900dca55c0d4049a9e615ce4f4e633a2020-11-24T21:46:34ZengKarger PublishersCase Reports in Dermatology1662-65672018-05-0110211011410.1159/000488077488077Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial SymptomYuki HattoriKanako MatsuyamaTomoko TakahashiEn ShuHiroyuki KanohMariko SeishimaPanniculitis is an uncommon skin eruption observed in patients with dermatomyositis (DM)/clinically amyopathic dermatomyositis (CADM), especially in anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive DM. We present here a 51-year-old Japanese woman with an anti-MDA5 antibody-positive DM who initially had cellulitis-like erythema on her right mandible. Histopathological findings showed a subcutaneous lobular infiltration of lymphocytes. The patient developed typical skin eruptions of DM/CADM, rapidly progressive interstitial lung disease, and severe muscle weakness 2 weeks after the first visit. After the diagnosis of anti-MDA5 antibody-positive DM, she was treated with intravenous steroid pulse therapy (methylprednisolone, 1,000 mg/day for 3 days), oral prednisolone at 1.0 mg/kg/day, and tacrolimus at 4.0 mg/day. The lesions of panniculitis associated with DM/CADM typically present on the buttocks, thighs, arms, and abdomen. This is the first DM/CADM case with localized panniculitis on the face. Panniculitis and myositis usually show simultaneous improvement during treatment. Although panniculitis disappeared with steroid and tacrolimus treatment and did not recur, muscle weakness was intractable and recurred in this case. This indicates that the clinical courses of panniculitis and myositis of DM/CADM do not always change in parallel.https://www.karger.com/Article/FullText/488077Anti-MDA5 antibodyRapidly progressive interstitial lung diseaseCellulitis-like erythemaDermatomyositisPanniculitis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuki Hattori Kanako Matsuyama Tomoko Takahashi En Shu Hiroyuki Kanoh Mariko Seishima |
spellingShingle |
Yuki Hattori Kanako Matsuyama Tomoko Takahashi En Shu Hiroyuki Kanoh Mariko Seishima Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial Symptom Case Reports in Dermatology Anti-MDA5 antibody Rapidly progressive interstitial lung disease Cellulitis-like erythema Dermatomyositis Panniculitis |
author_facet |
Yuki Hattori Kanako Matsuyama Tomoko Takahashi En Shu Hiroyuki Kanoh Mariko Seishima |
author_sort |
Yuki Hattori |
title |
Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial Symptom |
title_short |
Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial Symptom |
title_full |
Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial Symptom |
title_fullStr |
Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial Symptom |
title_full_unstemmed |
Anti-MDA5 Antibody-Positive Dermatomyositis Presenting with Cellulitis-Like Erythema on the Mandible as an Initial Symptom |
title_sort |
anti-mda5 antibody-positive dermatomyositis presenting with cellulitis-like erythema on the mandible as an initial symptom |
publisher |
Karger Publishers |
series |
Case Reports in Dermatology |
issn |
1662-6567 |
publishDate |
2018-05-01 |
description |
Panniculitis is an uncommon skin eruption observed in patients with dermatomyositis (DM)/clinically amyopathic dermatomyositis (CADM), especially in anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive DM. We present here a 51-year-old Japanese woman with an anti-MDA5 antibody-positive DM who initially had cellulitis-like erythema on her right mandible. Histopathological findings showed a subcutaneous lobular infiltration of lymphocytes. The patient developed typical skin eruptions of DM/CADM, rapidly progressive interstitial lung disease, and severe muscle weakness 2 weeks after the first visit. After the diagnosis of anti-MDA5 antibody-positive DM, she was treated with intravenous steroid pulse therapy (methylprednisolone, 1,000 mg/day for 3 days), oral prednisolone at 1.0 mg/kg/day, and tacrolimus at 4.0 mg/day. The lesions of panniculitis associated with DM/CADM typically present on the buttocks, thighs, arms, and abdomen. This is the first DM/CADM case with localized panniculitis on the face. Panniculitis and myositis usually show simultaneous improvement during treatment. Although panniculitis disappeared with steroid and tacrolimus treatment and did not recur, muscle weakness was intractable and recurred in this case. This indicates that the clinical courses of panniculitis and myositis of DM/CADM do not always change in parallel. |
topic |
Anti-MDA5 antibody Rapidly progressive interstitial lung disease Cellulitis-like erythema Dermatomyositis Panniculitis |
url |
https://www.karger.com/Article/FullText/488077 |
work_keys_str_mv |
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