Case ReportRituximab for the treatment of the skin manifestations of dermatomyositis: A report of 3 cases
Section snippets
Case 1
A 22-year-old woman was referred with an 8-year history of juvenile-onset classic DM complicated by mild interstitial lung disease. She demonstrated mechanics' hands (palmar hyperkeratosis) and long-standing poikilodermatous changes on her back and shoulders with violaceous erythema, postinflammatory hyperpigmentation, and superficial atrophy. Skin biopsy findings were consistent with DM. She had not complained of muscle symptoms for several years; her cutaneous lesions were the focus of
Discussion
DM is believed to be humorally mediated with activation of the complement system, resulting in deposition of the membrane attack complex in the capillaries of patients.12 Although the role of B cells in the development of DM has not been clearly established, the inflammatory infiltrates in the muscles of patients with DM have demonstrated more perivascular B lymphocytes than endomysial T lymphocytes.13 Indeed, the depletion of B cells by rituximab does closely parallel improvement in the muscle
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Cited by (80)
The role of bDMARDs in idiopathic inflammatory myopathies: A systematic literature review
2023, Autoimmunity ReviewsEmerging therapeutics in the management of connective tissue disease. Part II: Dermatomyositis and scleroderma
2022, Journal of the American Academy of DermatologyCitation Excerpt :Abatacept, a fusion protein composed of IgG1 fused to the extracellular domain of cytotoxic T-lymphocyte associated protein-4 approved for rheumatoid arthritis, has shown mild efficacy for both juvenile and adult patients with DM. Previous cases have demonstrated improvement in skin disease in both juvenile and adult patients with DM who were treated with rituximab.24-26 However, a pilot study of 8 patients found no significant change in cutaneous disease via the Dermatomyositis Skin Severity Index.27
Dermatomyositis: Diagnosis and treatment
2020, Journal of the American Academy of DermatologyHow I treat idiopathic patients with inflammatory myopathies in the clinical practice
2017, Autoimmunity ReviewsThe skin in autoimmune diseases—Unmet needs
2016, Autoimmunity ReviewsBiologic drugs in the treatment of juvenile dermatomyositis: a literature review
2024, Clinical Rheumatology
Funding sources: None.
Conflicts of interest: None identified.