Dermatomyositis syndrome in small cell lung cancer

Abstract

Dermatomyositis is a progressive systemic disease clinically manifested by a muscle lesion with impaired motor function as well as skin rashes, often in the form of erythema. In some cases, dermatomyositis can be the onset of cancer. In this regard, the doctor is required to be highly alert and focused on detecting the tumor process in patients with progressive muscle weakness and characteristic skin manifestations of dermatomyositis. The article presents a clinical case of paraneoplastic dermatomyositis co‐existing with small cell lung cancer. The malignancy was dia¬gnosed during cancer screening in a patient with classic manifestations of dermatomyositis. Improvement of clinical manifestations of dermatomyositis appeared with glucocorticosteroid therapy and surgical treatment, but the patient died, since small cell lung cancer has an aggressive clinical course with an unfavorable prognosis.

Keywords

dermatomyositis / paraneoplastic syndrome / autoimmune diseases / case report

References

[1] El-Azhary R.A., Pakzad S.Y. Amyopathic dermatomyositis: retrospective review of 37 cases. J. Am. Acad. Dermatol. 2002; 46: 560‒565. DOI: 10.1067/mjd.2002.120620.

[2] Chu L.L., Rohekar G. Dermatomyositis. CMAJ. 2019; 191 (12): E340. DOI: 10.1503/cmaj.180947.

[3] Callen J., Wortmann R. Dermatomyositis. Clin. Dermatol. 2006; 24 (5): 363–373. DOI: 10.1016/j.clindermatol.2006.07.001.

[4] Bohan A., Peter J.B., Bowman R.L., Pearson C.M. Computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore). 1977; 56 (4): 255–286. DOI: 10.1097/00005792-197707000-00001.

[5] Tymms K.E., Webb J. Dermatopolymyositis and ­other connective tissue diseases: A review of 105 cases. J. Rheumatol. 1985; 12 (6): 1140–1148. PMID: 4093921.

[6] Орлова Е.В., Плиева Л.Р., Пятилова П.М., Новосартян М.Г. Дерматомиозит: клинический случай и обзор литературы. Рус. мед. ж. 2017; 25 (11): 850–852. [­Orlova E.V., Plieva L.R., Pyatilova P.M., Novosartian M.G. Dermatomyositis: a clinical case and literature review. Rus­skiy meditsinskiy zhurnal. 2017; 25 (11): 850–852. (In Russ.)]

[7] Radenska-Lopovok S.G. Morphological differential diagnosis of the main types of inflammatory myopathies. Nervno-myshechnye bolezni. 2012; (1): 7‒11. (In Russ.)

[8] Раденска-Лоповок С.Г. Основные разновидности воспалительных миопатий: морфологическая дифференциальная диагностика. Нервно-мышечные болезни. 2012; (1): 7‒11.

[9] Rodionov A.N. Dermatovenerologija. (Dermatovenereology.) Polnoe rukovodstvo dlja vrachej. SPb.: Nauka i tehnika. 2014; 872 p. (In Russ.)

[10] Родионов А.Н. Дерматовенерология. Полное руководство для врачей. СПб.: Наука и техника. 2014; 872 с.

[11] Okorokov A.N. Diagnostika bolezney vnutrennikh organov. Tom 2. (Dia­gnosis of diseases of internal organs. Vol. 2.) M.: MedLit. 2004; 566 p. (In Russ.)

[12] Окороков А.Н. Диагностика болезней внутренних органов. Т. 2. М.: МедЛит. 2004; 566 с.

[13] Hill C., Zhang Y., Sigurgeirsson B. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. Lancet. 2001; 357 (9250): 96–100. DOI: 10.1016/S0140-6736(00)03540-6.

[14] Smirnova A.A., Simonova O.V. Paraneoplastic dermatomyositis: description of clinical case. Farmateka. 2018; (S2): 72–74. (In Russ.) DOI: 10.18565/pharmateca.2018.s2.72-74.

[15] Смирнова А.А., Симонова О.В. Паранеопластический дерматомиозит: описание клинического случая. Фарматека. 2018; (S2): 72–74. DOI: 10.18565/pharmateca.2018.s2.72-74.

[16] Mazurova V.I. Diffuznye bolezni soedinitel'noy tkani. (Diffuse diseases of connective tissue.) A guide for doctors. St. Petersburg: Special Lit. 2009; 192 p. (In Russ.)

[17] Мазурова В.И. Диффузные болезни соединительной ткани. Руководство для врачей. СПб.: СпецЛит. 2009; 192 с.

[18] Milone M. Diagnosis and management of immune-mediated myopathy. Mayo Clin. Proc. 2017; 92 (5): 826–837. DOI: 10.1016/j.mayocp.2016.12.025.

[19] Ganshina I.P., Zhukova L.G., Burne­vitch E.Z. et al. Dermatomyositis and polymyositis in breast cancer patients: a case reports. Sovremennaya onkologiya. 2018; 20 (1): 42–44. (In Russ.)

[20] Ганьшина И.П., Жукова Л.Г., Бурневич Э.З. и др. Дерматомиозит и полимиозит у больных раком молочной железы: клинические случаи. Соврем. онкол. 2018; 20 (1): 42–44.

[21] Choy E., Isenberg D. Treatment of dermatomyositis and polymyositis. Rheumatology. 2002; 41 (1): 7–13.

[22] Dikareva E.A., Velichinskaya O.G. Dermatomyo­sitis (clinical case). Vestnik VGMU. 2019; 18 (2): 116–122. (In Russ.) DOI: 10.22263/2312-4156.2019.2.116.

[23] Дикарева Е.А., Величинская О.Г. Дерматомиозит (клинический случай). Вестн. ВГМУ. 2019; 18 (2): 116–122. DOI: 10.22263/2312-4156.2019.2.116.

[24] Zykova A.S., Novikov P.I., Moiseev S.V. Adult dermatomyositis: new classification criteria and mo­dern treatment. Klinicheskaya farmakologiya. 2017; 26 (2): 83–92. (In Russ.)

[25] Зыкова А.С., Новиков П.И., Моисеев С.В. Дерматомиозит взрослых: новые критерии диагностики и перспективы терапии. Клин. фармакол. и терап. 2017; 26 (2): 83–92.

[26] Antelava O.A. The specific features of the onset, clinical picture, steroid responsiveness of paraneoplastic myositis. Rheumatology Science and Practice. 2013; (2): 181–185. (In Russ.) DOI: 10.14412/1995-4484-2013-647.

[27] Антелава О.А. Паранеопластический миозит. Особенности дебюта, клинической картины, течения, стероид-респонсивность. Науч.-практ. ревматол. 2013; (2): 181–185. DOI: 10.14412/1995-4484-2013-647.

[28] Ankudinov A.S., Ka­lyagin A.N., Chernykh S.Yu. Paraneoplastic myositis. ­Sibirskiy meditsinskiy zhurnal (Irkutsk). 2013; (3): 120–123. (In Russ.)

[29] Анкудинов А.С., Калягин А.Н., Черных С.Ю. Паранеопластический миозит. Сибирский мед. ж. (Иркутск). 2013; (3): 120–123.

[30] Antiochos B., Brown L., Li Z. Malignancy is associated with dermatomyositis but not polymyositis in Nor­thern New England, USA. J. Rheumatol. 2009; 36 (12): 2704–2710. DOI: 10.3899/jrheum.090549.

[31] Sigurgeirsson B., Lindelof B., Edhag O. Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N. Eng. J. Med. 1992; 326 (6): 363–367. DOI: 10.1056/NEJM199202063260602.

[32] Stockton D., Doherty V., Brewster D. Risk of cancer in patients with dermatomyositis or polymyositis, and follow-up implications: a Scottish population-based cohort study. Br. J. Cancer. 2001; 85 (1): 41–45. DOI: 10.1054/bjoc.2001.1699.

[33] Minimum cli­nical recommendations of the European Society for Medical Oncology (ESMO). Ed. by (Russian translation) S.A. Tyulyandin, D.A. Nosov, N.I. Perevodchikova. M.: Publication. RONC group named after N.N. Blokhin RAMS. 2010; 170–186 p. (In Russ.)

[34] Минимальные клинические рекомендации Европейского общества медицинской онкологии (ESMO). Редакторы русского перевода С.А. Тюляндин, Д.А. Носов, Н.И. Переводчикова. М.: Издат. группа РОНЦ им. Н.Н. Блохина РАМН. 2010; 170–186 с.

RIGHTS & PERMISSIONS

Musin S.T., Berezhnoy S.G., Khrapova I.A., Romanovskaya E.V., Ovsyannikov N.V., Drokina O.V.