en
Scientific article
Case report
English

Dermatomyositis, lobar panniculitis and inflammatory myopathy with abundant macrophages

Published inNeuromuscular Disorders, vol. 16, no. 7, p. 468-471
Publication date2006
Abstract

Dermatomyositis (DM) is a rare treatable muscle disorder with a reported favorable outcome in most patients. A localized skin/muscle involvement in a DM patient raises questions of definition and causes such as lymphoma, or relapse. We describe here a young treated DM patient who presented a focal biopsy-proven destructive myositis and dermatitis restricted to the left thigh 15 months after the onset of a treated dermatomyositis. There was evidence of subcutaneous lobular panniculitis, somewhat resembling cytophagic histocytic panniculitis associated with a focal inflammatory myopathy with abundant macrophages that destroyed the sartorius muscle. Mild signs of hemophagocytosis and T-CD3 lymphocytosis were present in the bone marrow, but no monoclonal T-lymphocyte expansion was observed, as searched by autoradiography of the totality of TcR Vgamma families. The patient improved with prednisone and azathioprine. We conclude that this focal complication suggests a continuum between dermatomyositis, CHP, and IMAM, the three syndromes where T-cell activation plays an important role.

Keywords
  • Adult
  • Biopsy
  • Dermatomyositis/immunology/pathology
  • Humans
  • Macrophages/pathology
  • Magnetic Resonance Imaging
  • Male
  • Muscle, Skeletal/pathology
  • Myositis/immunology/pathology
  • Panniculitis/immunology/pathology
Affiliation Not a UNIGE publication
Citation (ISO format)
CARRERA, Emmanuel et al. Dermatomyositis, lobar panniculitis and inflammatory myopathy with abundant macrophages. In: Neuromuscular Disorders, 2006, vol. 16, n° 7, p. 468–471. doi: 10.1016/j.nmd.2006.05.008
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Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal0960-8966
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