Article: article d'un périodique ou d'un magazine.
Etude de cas (case report): rapporte une observation et la commente brièvement.
Dermatomyositis, lobar panniculitis and inflammatory myopathy with abundant macrophages
Date de publication
Case Reports Journal Article --- Old month value: Jul
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.
Adult Biopsy Dermatomyositis/immunology/*pathology Humans Macrophages/*pathology Magnetic Resonance Imaging Male Muscle, Skeletal/pathology Myositis/immunology/*pathology Panniculitis/immunology/*pathology
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