V Vuong1, T A Duong1, J Aouizerate2,3, F J Authier2,3, S Ingen-Housz-Oro1,4, L Valeyrie-Allanore1,4, N Ortonne2, P Wolkenstein1,4, R K Gherardi2,3, O Chosidow1,4,5, A Cosnes1, E Sbidian1,4,5. 1. AP-HP, DHU-VIC, Service de Dermatologie, Hôpitaux universitaires Henri Mondor, Créteil, France. 2. AP-HP, Département de Pathologie, Centre de référence des pathologies neuromusculaires, Hôpitaux universitaires Henri Mondor, Créteil, France. 3. Université Paris Est, IMRB, INSERM U955-Unité 10, Créteil, France. 4. Université Paris Est, IMRB, EA 7379 EpiDermE, Créteil, France. 5. Université Paris Est, INSERM, CIC 1430, Créteil, France.
Abstract
BACKGROUND: The course of dermatomyositis (DM) can be chronic with relapses, which are associated with major morbidity. OBJECTIVE: The aim of this study was to identify presentation features that predict DM relapses. METHODS: We retrospectively reviewed data of patients with DM recorded from 1990 to 2011, including muscle biopsy results. Characteristics of patients with and without relapses were compared. Hazard ratios (HRs) were estimated using a Cox model. RESULTS: We identified 34 patients, with a mean age of 46 ± 17 years (range, 18-77) and 24 (71%) women. The muscle and skin abnormalities relapsed in 21 (61%) patients. By univariate analysis, two presentation features were significantly associated with a subsequently relapsing course, namely, dysphonia [HR = 3.2 (1.2-8.5)] and greater skin lesion severity defined as a Cutaneous Disease Area Severity Index [CDASI] > 20 [HR = 3.5 (1.2-7.9)]. CONCLUSION: Dysphonia and skin lesion severity at disease onset must be recorded, as they significantly predict a relapsing disease course.
BACKGROUND: The course of dermatomyositis (DM) can be chronic with relapses, which are associated with major morbidity. OBJECTIVE: The aim of this study was to identify presentation features that predict DM relapses. METHODS: We retrospectively reviewed data of patients with DM recorded from 1990 to 2011, including muscle biopsy results. Characteristics of patients with and without relapses were compared. Hazard ratios (HRs) were estimated using a Cox model. RESULTS: We identified 34 patients, with a mean age of 46 ± 17 years (range, 18-77) and 24 (71%) women. The muscle and skin abnormalities relapsed in 21 (61%) patients. By univariate analysis, two presentation features were significantly associated with a subsequently relapsing course, namely, dysphonia [HR = 3.2 (1.2-8.5)] and greater skin lesion severity defined as a Cutaneous Disease Area Severity Index [CDASI] > 20 [HR = 3.5 (1.2-7.9)]. CONCLUSION:Dysphonia and skin lesion severity at disease onset must be recorded, as they significantly predict a relapsing disease course.