Clinicalanalysis Of63Cases Of Dermatomyositis

Dermatomyositis(DM) is a kind of autoimmune connective tissuedisease characterized with non suppurative inflammation of skin andstriated muscle, with subacute and chronic diseases. The disease mightoccur at any age and peaked in childhood and40~60years old.Incidence ofmale patients and female patients is about1:2. The etiology andpathogenesis of DM remains unknown.The clinical manifestations of DMis diversity, with skin lesions of erythema, edema, accompanied byamyasthenia and muscle inflammation, degeneration, involved inmultiple organs.The clinical course is changeable, when involving theswallowing muscles, respiratory muscle or pulmonary interstitial fibrosis,can endanger life.DM patients with malignant tumor of the concurrent rateis high, the prognosis is poor, now the disease has caused clinician paymore attention. In this paper, a retrospective analysis of63DM patients clinical data in our hospital department of Dermatology and department ofRheumatology2003~2013.Objective: To study the clinical manifestations and characteristics ofdermatomyositis. Especially the relationship between the rash, laboratoryexamination, interstitial lung disease(ILD), the tumor and other clinicalindicators.Methods: To retrospectively analyze with63patients’ clinicalmanifestation, laboratory examination, electromyography and musclebiopsy etc. Data were analyzed using statistical software SPSS18.0,comparison between group by t test, counting data by chi-square test.α=0.05as the testing standard, bilateral inspection, P<0.05, there wasstatistically significant difference, P>0.05, there was no statisticallysignificant difference.Results:21cases of male,42cases of male, male: female1:2. Initialage of men between35to81years old, average (59.08±5.46). Initial ageof women between24to80years old, average (49.29±4.86).Among them,21~40years old group have13cases (20.64%),41~60years old grouphave29cases (46.03%),61~81years old group have21cases (33.33%).The course of disease was3~100months, average (15.3±5.7) months. Itcosts1.2months~38months to diagnose the disease, the average (6.4±3.2)months. Initial symptoms followed by skin rash (69.84%), joint pain(11.11%), muscle symptoms (9.52%), skin rashes and muscle symptoms appear at the same time (9.52%). Rash in patients with periorbitalaubergine plaques (92.06%), chest V area erythema (57.14%) and Gottronpapule (57.14%).58patients took EMG examination,55cases (94.83%)showed muscle source damage and mixed damage.46patients took musclebiopsies,42cases (91.30%) were positive. There are13cases in this groupof patients with a clear diagnosis of tumor, imageology and tumor markersdetection in4patients were strongly suggest tumor exists, but the patientand family refuse to take further examination.13cases of patients withdefinite diagnosis and4cases of suspected diagnosis were above40yearsold. Serum muscle enzymes increased in the patients with ALT, LDH, CK,AST, HBDH and CK-MB, and LDH, ALT had a higher sensitivity, whileCK with high specificity,but the sensitivity is inferior to LDH, AST, ALTand HBDH. Anti J0-1antibody is labeled antibody of DM, but only9cases (7cases with ILD) of anti J0-1antibody positive, shows that thesensitivity is not high, but the positive rate is higher in patients withpulmonary interstitial changes, so find anti J0-1antibody positive, shouldbe timely check the lungs.Conclusion: The peak morbidity of dermatomyositis is childhood and40~60years old, ratio of male and female patients was1:2. Initialsymptoms was varied, skin rash was most common, periorbital aubergineplaques was most important, with diagnostic significance. Muscle biopsyand EMG is of great significance in the diagnosis of dermatomyositis. In elderly patients with DM should make comprehensive inspection, in orderto rule out the possibility of malignant tumor, the DM patients under theage of40, also cannot let down, should be vigilant.1patients with ovariancancer diagnosed after surgery, skin rashes and muscle symptoms graduallyimproved, serum muscle enzymes continues to decline, this tell us partdermatomyositis patients with malignant tumor symptoms also improvedafter tumor control. Serum muscle enzymes are one of the important indexfor diagnosis and evaluation of treatment effect, but not to rely too much onthe change and adjust the treatment plan.