Anne M Seidler1, Alice B Gottlieb. 1. Department of Dermatology, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts 02111-1533, USA. anne.seidler@alumni.tufts.edu
Abstract
BACKGROUND: Drugs have occasionally been implicated in dermatomyositis (DM) onset. OBJECTIVE: We sought to review case reports of drug-induced DM. METHODS: Articles were gathered from MEDLINE and bibliographies of acquired reports. Causality was assessed using World Health Organization criteria. Clinical characteristics, management, and resolution were examined. RESULTS: In 70 reported cases, 50% of patients were female and the median age was 57 years. Hydroxyurea was implicated in 51% of cases. All cases had pathognomonic (76%) or compatible (24%) cutaneous findings. Hydroxyurea cases lacked myositis, but myositis was described in 79.4% of nonhydroxyurea cases. Drug causality was probable (25.7%) or possible (74.3%), but not certain in any case. Most patients had underlying pathology associated with DM (44% had malignancy; 16% had rheumatoid arthritis). Of the sample, 84.3% had improvement of DM after discontinuation of the drug. LIMITATIONS: Case reports may emphasize unusual findings. CONCLUSIONS: Further work is needed to differentiate drug effects from underlying, predisposing factors.
BACKGROUND: Drugs have occasionally been implicated in dermatomyositis (DM) onset. OBJECTIVE: We sought to review case reports of drug-induced DM. METHODS: Articles were gathered from MEDLINE and bibliographies of acquired reports. Causality was assessed using World Health Organization criteria. Clinical characteristics, management, and resolution were examined. RESULTS: In 70 reported cases, 50% of patients were female and the median age was 57 years. Hydroxyurea was implicated in 51% of cases. All cases had pathognomonic (76%) or compatible (24%) cutaneous findings. Hydroxyurea cases lacked myositis, but myositis was described in 79.4% of nonhydroxyurea cases. Drug causality was probable (25.7%) or possible (74.3%), but not certain in any case. Most patients had underlying pathology associated with DM (44% had malignancy; 16% had rheumatoid arthritis). Of the sample, 84.3% had improvement of DM after discontinuation of the drug. LIMITATIONS: Case reports may emphasize unusual findings. CONCLUSIONS: Further work is needed to differentiate drug effects from underlying, predisposing factors.
Authors: Lisa G Rider; Lan Wu; Gulnara Mamyrova; Ira N Targoff; Frederick W Miller Journal: Rheumatology (Oxford) Date: 2010-08-27 Impact factor: 7.580