Intractable skin necrosis and interstitial pneumonia in amyopathic dermatomyositis, successfully treated with cyclosporin A.

Abstract

We report a patient with amyopathic dermatomyositis (DM) who mainly showed interstitial pneumonia and intractable skin necrosis in bilateral elbows and soles with a poor response to immunomediated therapy, including corticosteroid and high-dose intravenous immunoglobulin. Soon after starting oral cyclosporin A (CyA) the skin lesions healed completely and the interstitial pneumonia promptly improved in parallel with a decrease in serum KL-6. Since fatal interstitial pneumonia is frequently associated with amyopathic DM as in this case, administration of CyA should be actively considered as a therapeutic option when clinical symtoms are progressive and resistant to conventional treatments.

• Authors: Yasuhiro Shimojima, Wataru Ishii, Takashi Kato, Kenichi Hoshi, Masayuki Matsuda, Takao Hashimoto, Yukio Tanaka, Shu-ichi Ikeda
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 42 Issue 12 Pg. 1253-8 (Dec 2003) ISSN: 0918-2918 [Print] Japan
• PMID: 14714970 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins, Intravenous
• Immunosuppressive Agents
• Cyclosporine

Topics

• Adult
• Cyclosporine (therapeutic use)
• Dermatomyositis (complications, drug therapy)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunosuppressive Agents (therapeutic use)
• Lung Diseases, Interstitial (drug therapy, etiology)
• Male
• Necrosis
• Skin (pathology)