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Seminars in Immunopathology
Published in: Seminars in Immunopathology 1/2016

01-01-2016 | Review

Cutaneous dermatomyositis in the era of biologicals

Authors: Natalie A. Wright, Ruth Ann Vleugels, Jeffrey P. Callen

Published in: Seminars in Immunopathology | Issue 1/2016

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Abstract

Dermatomyositis (DM) is a systemic inflammatory condition characterized by cutaneous and muscle findings, in addition to potential involvement of other organ systems. A distinct subtype of DM exists that is categorized by cutaneous findings with absent or minimal muscle involvement, referred to as clinically amyopathic dermatomyositis or dermatomyositis sine myositis. A variety of topical, immunosuppressive, and immunomodulatory therapies have been utilized to treat cutaneous DM. The advent of biological agents including tumor necrosis factor-α antagonists, intravenous immunoglobulin, rituximab, and others has allowed for the use of these agents with varying degrees of success for the treatment of cutaneous DM.
Literature
1.
Sontheimer RD (2002) Would a new name hasten the acceptance of amyopathic dermatomyositis (dermatomyositis sine myositis) as a distinctive subset within the idiopathic inflammatory dermatomyopathies spectrum of clinical illness? J Am Acad Dermatol 46:626–36PubMedCrossRef
2.
Anyanwu CO, Fiorentino DF, Chung L, Dzuong C, Wang Y, et al. (2015) validation of the cutaneous dermatomyositis disease area and severity index: characterizing disease severity and assessing responsiveness to clinical change. Br J Dermatol. Epub ahead of print
3.
Lundberg I, Brengman JM, Engel AG (1995) Analysis of cytokine expression in muscle in inflammatory myopathies, Duchenne dystrophy, and non-weak controls. J Neuroimmunol 63:9–16PubMedCrossRef
4.
Kuru S, Inukai A, Liang Y, Doyu M, Takano A, Sobue G (2000) Tumor necrosis factor-alpha expression in muscles of polymyositis and dermatomyositis. Acta Neuropathol 99:585–588PubMedCrossRef
5.
Pachman LM, Fedczyna TO, Lechman TS, Lutz J (2001) Juvenile dermatomyositis: the association of the TNF alpha-308A allele and disease chronicity. Curr Rheumatol Rep 3:379–386PubMedCrossRef
6.
Klein R, Rosenbach M, Kim EJ, Kim B, Werth VP, Dunham J (2010) Tumor necrosis factor inhibitor-associated dermatomyositis. Arch Dermatol 146:780–784PubMedPubMedCentral
7.
Riolo G, Towheed TE (2012) Anti–tumor necrosis factor inhibitor therapy–induced dermatomyositis and fasciitis. J Rheumatol 39:192–194PubMed
8.
Brunasso AM, Scocco GL, Massone C (2010) Dermatomyositis during adalimumab therapy for rheumatoid arthritis. J Rheumatol 37:1549–1550PubMedCrossRef
9.
Liu SW, Velez NF, Lam C, Femia A, Granter SR, Townsend HB, Vleugels RA (2013) Dermatomyositis induced by anti-tumor necrosis factor in a patient with juvenile idiopathic arthritis. JAMA Dermatol 149:1204–1208PubMedCrossRef
10.
Hall HA, Zimmermann B (2006) Evolution of dermatomyositis during therapy with a tumor necrosis factor alpha inhibitor. Arthritis Rheum 55:982–984PubMedCrossRef
11.
Ishikawa Y, Yukawa N, Ohmura K, Hosono Y, Imura Y et al (2010) Etanercept-induced anti-Jo-1-antibody–positive polymyositis in a patient with rheumatoid arthritis: a case report and review of the literature. Clin Rheumatol 29:563–566PubMedCrossRef
12.
Musial J, Undas A, Celińska-Lowenhoff M (2003) Polymyositis associated with infliximab treatment for rheumatoid arthritis. Rheumatology (Oxford) 42:1566–1568CrossRef
13.
Urata Y, Wakai Y, Kowatari K, Nitobe T, Mizushima Y (2006) Polymyositis associated with infliximab treatment for rheumatoid arthritis. Mod Rheumatol 16:410–411PubMedCrossRef
14.
Liozon E, Ouattara B, Loustaud-Ratti V, Vidal E (2007) Severe polymyositis and flare in autoimmunity following treatment with adalimumab in a patient with overlapping features of polyarthritis and scleroderma. Scand J Rheumatol 36:484–486PubMedCrossRef
15.
Ishikawa Y, Yukawa N, Kawabata D, Ohmura K, Fujii T et al (2011) A case of antisynthetase syndrome in a rheumatoid arthritis patient with anti-PL-12 antibody following treatment with etanercept. Clin Rheumatol 30:429–432PubMedCrossRef
16.
Ishiguro T, Takayanagi N, Miyahara Y, Yanagisawa T, Sugita Y (2010) Antisynthetase (anti PL-7 antibody) syndrome presenting as a skin rash and exacerbation of interstitial pneumonia during treatment for rheumatoid arthritis [in Japanese]. Nihon Kokyuki Gakkai Zasshi 48:240–246PubMed
17.
Norman R, Greenberg RG, Jackson JM (2006) Case reports of etanercept in inflammatory dermatoses. J Am Acad Dermatol 54:S139–142PubMedCrossRef
18.
Iannone F, Scioscia C, Falappone PC, Covelli M, Lapadula G (2006) Use of etanercept in the treatment of dermatomyositis: a case series. J Rheumatol 33:1802–1804PubMed
19.
Rouster-Stevens KA, Ferguson L, Morgan G, Huang CC, Pachman LM (2014) Pilot study of etanercept in patients with refractory juvenile dermatomyositis. Arthritis Care Res 66:783–787CrossRef
20.
Muscle Study Group (2011) A randomized, pilot study of etanercept in dermatomyositis. Ann Neurol 70:427–436CrossRef
21.
Chen D, Wang XB, Zhou Y, Zhu XC (2013) Efficacy of infliximab in the treatment for dermatomyositis with acute interstitial pneumonia: a study of fourteen cases and literature review. Rheumatol Int 33:2455–2458PubMedCrossRef
22.
Dold S, Justiniano ME, Marquez J, Espinoza LR (2007) Treatment of early and refractory dermatomyositis with infliximab: a report of two cases. Clin Rheumatol 26:1186–1188PubMedCrossRef
23.
Riley P, McCann LJ, Maillard SM, Woo P, Murray KJ, Pilkington CA (2008) Effectiveness of infliximab in the treatment of refractory juvenile dermatomyositis with calcinosis. Rheumatology(Oxford) 47:877–880CrossRef
24.
Hengstman GJ, De Bleecker JL, Feist E, Vissing J, Denton CP et al (2008) Open-label trial of anti-TNF-alpha in dermato- and polymyositis treated concomitantly with methotrexate. Eur Neurol 59:159–163PubMedCrossRef
25.
Park JK, Yoo HG, Ahn DS, Jeon HS, Yoo WH (2012) Successful treatment for conventional treatment-resistant dermatomyositis-associated interstitial lung disease with adalimumab. Rheumatol Int 32:3587–3590PubMedCrossRef
26.
da Silva TC, Zon Pretti F, Shinjo SK (2013) Adalimumab in anti-synthetase syndrome. Joint Bone Spine 80:432PubMedCrossRef
27.
Jolles S, Hughes J, Whittaker S (1998) Dermatological uses of high-dose intravenous immunoglobulin. Arch Dermatol 134:80–86PubMedCrossRef
28.
Dalakas MC (2014) Mechanistic effects of IVIg in neuroinflammatory diseases: conclusions based on clinicopathologic correlations. J Clin Immunol 34:S120–6PubMedCrossRef
29.
Saito E, Koike T, Hashimoto H, Miyasaka N, Ikeda Y et al (2008) Efficacy of high-dose intravenous immunoglobulin therapy in Japanese patients with steroid-resistant polymyositis and dermatomyositis. Mod Rheumatol 18:34–44PubMedCrossRef
30.
Gottfried I, Seeber A, Anegg B, Rieger A, Stingl G, Volc-Platzer B (2000) High dose intravenous immunoglobulin (IVIg) in dermatomyositis: clinical responses and effect on sIL-2R levels. Eur J Dermatol 10:29–35PubMed
31.
Dalakas MC, Illa I, Dambrosia JM, Soueidan SA, Stein DP et al (1993) A controlled trial of high-dose intravenous immune globulin infusions as treatment for dermatomyositis. N Engl J Med 329:1993–2000PubMedCrossRef
32.
Femia AN, Vleugels RA, Callen JP (2013) Cutaneous dermatomyositis: an updated review of treatment options and internal associations. Amer J Clin Dermatol 14:291–313CrossRef
33.
Bounfour T, Bouaziz JD, Bezier M, Cordoliani F, Saussine A et al (2014) Clinical efficacy of intravenous immunoglobulins for the treatment of dermatomyositis skin lesions without muscle disease. J Eur Acad Dermatol Venereol 28:1150–1157PubMedCrossRef
34.
Danieli MG, Malcangi G, Palmieri C, Logullo F, Salvi A et al (2002) Cyclosporin A and intravenous immunoglobulin treatment in polymyositis/dermatomyositis. Ann Rheum Dis 61:37–41PubMedPubMedCentralCrossRef
35.
Danieli MG, Calcabrini L, Calabrese V, Marchetti A, Logullo F, Gabrielli A (2009) Intravenous immunoglobulin as add on treatment with mycophenolate mofetil in severe myositis. Autoimm Rev 9:124–127CrossRef
36.
Kampylafka EI, Kosmidis ML, Panagiotakos DB, Dalakas M, Moutsopoulos HM, Tzioufas AG (2012) The effect of intravenous immunoglobulin (IVIg) treatment on patients with dermatomyositis: a 4-year follow-up study. Clin Exp Rheumatol 30:397–401PubMed
37.
Danieli MG, Pettinari L, Moretti R, Logullo F, Gabrielli A (2011) Subcutaneous immunoglobulin in polymyositis and dermatomyositis: a novel application. Autoimmun Rev 10:144–149PubMedCrossRef
38.
Danieli MG, Moretti R, Gambini S, Paolini L, Gabrielli A (2014) Open-label study on treatment with 20% subcutaneous IgG administration in polymyositis and dermatomyositis. Clin Rheumatol 33:531–536PubMedCrossRef
39.
Penate Y, Guillermo P, Melwani P, Martel R, Hernandez-Machin B et al (2009) Calcinosis cutis associated with amyopathic dermatomyositis: response to intravenous immunoglobulin. J Am Acad Dermatol 60:1076–1077PubMedCrossRef
40.
41.
Levine TD (2005) Rituximab in the treatment of dermatomyositis: an open-label pilot study. Arthritis Rheum 52:601–607PubMedCrossRef
42.
Noss EH, Hausner-Sypek DL, Weinblatt ME (2006) Rituximab as therapy for refractory polymyositis and dermatomyositis. J Rheumatol 33:1021–1026PubMed
43.
Chiappetta N, Steier J, Gruber B (2005) Rituximab in the treatment of refractory dermatomyositis. J Clin Rheumatol 11:264–266PubMedCrossRef
44.
Lambotte O, Kotb R, Maigne G, Blanc FX, Goujard C, Delfraissy JF (2005) Efficacy of rituximab in refractory polymyositis. J Rheumatol 32:1369–1370PubMed
45.
Dinh HV, McCormack C, Hall S, Prince HM (2007) Rituximab for the treatment of the skin manifestations of dermatomyositis: a report of 3 cases. J Am Acad Dermatol 56:148–153PubMedCrossRef
46.
Touma Z, Arayssi T, Kibbi L, Masri AF (2008) Successful treatment of cardiac involvement in dermatomyositis with rituximab. Joint Bone Spine 75:334–337PubMedCrossRef
47.
Chung L, Genovese MC, Fiorentino DF (2007) A pilot trial of rituximab in the treatment of patients with dermatomyositis. Arch Dermatol 143:763–767PubMedCrossRef
48.
Feist E, Dorner T, Sorensen H, Burmester GR (2008) Longlasting remissions after treatment with rituximab for autoimmune myositis. J Rheumatol 35:1230–1232PubMed
49.
Mahler EA, Blom M, Voermans NC, van Engelen BG, van Riel PL, Vonk MC (2011) Rituximab treatment in patients with refractory inflammatory myopathies. Rheumatology(Oxford) 50:2206–2213CrossRef
50.
Sultan SM, Ng KP, Edwards JC, Isenberg DA, Cambridge G (2008) Clinical outcome following B cell depletion therapy in eight patients with refractory idiopathic inflammatory myopathy. Clin Exp Rheumatol 26:887–893PubMed
51.
Kaposztas Z, Etheridge WB, Kahan BD (2008) Case report: successful treatment of posttransplant lymphoproliferative disorder and quiescence of dermatomyositis with rituximab and sirolimus. Transplant Proc 40:1744–1746PubMedCrossRef
52.
Haroon M, Devlin J (2012) Rituximab as a first-line agent for the treatment of dermatomyositis. Rheumatol Int 32:1783–1784PubMedCrossRef
53.
Parziale N, Kovacs SC, Thomas CB, Srinivasan J (2011) Rituximab and mycophenolate combination therapy in refractory dermatomyositis with multiple autoimmune disorders. J Clin Neuromuscul Dis 13:63–67PubMedCrossRef
54.
Unger L, Kampf S, Luthke K, Aringer M (2014) Rituximab therapy in patients with refratory dermatomyositis or polymyositis: diferential effects in a real-life population. Rheumatology (Oxford) 53:1630–1638CrossRef
55.
Cooper MA, Willingham DL, Brown DE, French AR, Shih FF, White AJ (2007) Rituximab for the treatment of juvenile dermatomyositis: a report of four pediatric patients. Arthritis Rheum 56:3107–3111PubMedCrossRef
56.
Bader-Meunier B, Decaluwe H, Barnerias C, Gherardi R, Quartier P, Faye A et al (2011) Safety and efficacy of rituximab in severe juvenile dermatomyositis: results from 9 patients from the French Autoimmunity and Rituximab registry. J Rheumatol 38:1436–1440PubMedCrossRef
57.
Oddis CV, Reed AM, Aggarwal R, Rider LG, Ascherman DP et al (2013) Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial. Arthritis Rheum 65:314–324PubMedPubMedCentralCrossRef
58.
Aggarwal R, Bandos A, Reed AM, Ascherman DP, Barohn RJ et al (2014) Predictors of clinical improvement in rituximab-treated refractory adult and juvenile dermatomyositis and adult polymyositis. Arthritis Rheumatol 66:740–749PubMedPubMedCentralCrossRef
59.
Hornung T, Janzen V, Heidgen FJ, Wolf D, Bieber T et al (2014) Remission of recalcitrant dermatomyositis treated with ruxolitinib. N Engl J Med 371:2537–2538PubMedCrossRef
60.
Zong M, Dorph C, Dastmalchi M, Alexanderson H, Pieper J et al (2014) Anakinra treatment in patients with refractory inflammatory myopathies and possible predictive response biomarkers: a mechanistic study with 12 months follow-up. Ann Rheum Dis 73:913–920PubMedCrossRef
61.
Arabshahi B, Silverman RA, Jones OY, Rider LG (2012) Abatacept and sodium thiosulfate for treatment of recalcitrant juvenile dermatomyositis complicated by ulceration and calcinosis. J Pediatr 160:520–522PubMedPubMedCentralCrossRef
62.
Tjarnlund A, Dastmalchi M, Mann H, Tomasova Studynkova J, Chura R et al (2015) Abatacept in the treatment of adult dermatomyositis and polymyositis: artermis, a randomized, treatment delayed-start trial. Ann Rheum Dis 74:817CrossRef
63.
Isenberg DA, Rowe D, Shearer M, Novick D, Beverley PC (1986) Localization of interferons and interleukin 2 in polymyositis and muscular dystrophy. Clin Exp Immunol 63:450–458PubMedPubMedCentral
64.
Greenberg SA, Pinkus JL, Pinkus GS, Burleson T, Sanoudou D et al (2005) Interferon-alpha/beta-mediated innate immune mechanisms in dermatomyositis. Ann Neurol 57:664–678PubMedCrossRef
65.
Wenzel J, Schmidt R, Proelss J, Zahn S, Bieber T et al (2006) Type I interferon-associated skin recruitment of CXCR3+ lymphocytes in dermatomyositis. Clin Exp Dermatol 31:576–582PubMedCrossRef
66.
Greenberg SA, Higgs BW, Morehouse C, Walsh RJ, Kong SW et al (2012) Relationship between disease activity and type 1 interferon- and other cytokine-inducible gene expression in blood in dermatomyositis and polymyositis. Genes Immun 13:207–213PubMedCrossRef
67.
Walsh RJ, Kong SW, Yao Y, Jalial B, Kiener PA et al (2007) Type I interferon-inducible gene expression in blood is present and reflects disease activity in dermatomyositis and polymyositis. Arthritis Rheum 56:3784–3792PubMedPubMedCentralCrossRef
68.
Baechler EC, Bauer JW, Slattery CA, Ortmann WA, Novitzke J et al (2007) An interferon signature in the peripheral blood of dermatomyositis patients is associated with disease activity. Mol Med 13:59–68PubMedPubMedCentralCrossRef
69.
Higgs BW, Zhu W, Morehouse C, White WI, Brohawn P et al (2014) A phase 1b clinical trial evaluating sifalimumab, an anti-IFN-α monoclonal antibody, shows target neutralisation of a type I IFN signature in blood of dermatomyositis and polymyositis patients. Ann Rheum Dis 73:256–262PubMedPubMedCentralCrossRef
70.
Liao AP, Salajegheh M, Nazareno R, Kagan JC, Jubin RG et al (2011) Interferon β is associated with type 1 interferon-inducible gene expression in dermatomyositis. Ann Rheum Dis 70:831–836PubMedCrossRef
71.
Bilgic H, Ytterberg SR, Amin S, McNallan KT, Wilson JC (2009) Interleukin-6 and type I interferon-regulated genes and chemokines marks disease activity in dermatomyositis. Arthritis Rheum 60:3436–3446PubMedCrossRef
72.
Kondo M, Murakawa Y, Matsumura T, Matsumoto O, Taira M (2014) A case of overlap syndrome successfully treated with tocilizumab: a hopeful treatment strategy for refractory dermatomyositis? Rheumatology (Oxford) 53:1907–908CrossRef
73.
Danko K, Vencovsky J, Lundberg IE, Amato AA, Oddis CV et al (2014) The selective sphingosine-1-phosphate receptor 1/5 modulator siponimod(BAF312) shows beneficial effects in patients with active, treatment refractory polymyositis and dermatomyositis:a phase IIa proof-of-concept, double-blind, randomized trial. American college of rheumatology annual meeting. MA, Boston
Metadata
Title
Cutaneous dermatomyositis in the era of biologicals
Authors
Natalie A. Wright
Ruth Ann Vleugels
Jeffrey P. Callen
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Seminars in Immunopathology / Issue 1/2016
Print ISSN: 1863-2297
Electronic ISSN: 1863-2300
DOI
https://doi.org/10.1007/s00281-015-0543-z

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