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CLINICAL RESEARCH
Cutaneous ulcers in anti-MDA5-positive dermatomyositis with rapidly progressive interstitial lung disease: a multicentre retrospective cohort study
1
Department of Rheumatology and Immunology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
2
Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
3
Department of Rheumatology and Immunology, Wuxi People’s Hospital, Wuxi, Jiangsu, China
4
Department of Rheumatology and Immunology, Huai’an First People’s Hospital, Huai’an, Jiangsu, China
5
Department of Rheumatology and Immunology, The First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
6
Department of Rheumatology and Immunology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
7
Department of Rheumatology and Immunology, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, China
8
Department of Rheumatology and Immunology, Changzhou No. 2 People’s Hospital, Changzhou, Jiangsu, China
9
Department of Rheumatology and Immunology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
10
Department of Rheumatology and Immunology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, Chin
11
Department of Rheumatology and Immunology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
12
Department of Rheumatology and Immunology, Nanjing First Hospital, Nanjing, Jiangsu, China
13
Department of Rheumatology and Immunology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
14
Department of Rheumatology and Immunology, Yancheng No. 1 People’s Hospital, Yancheng, Jiangsu, China
15
Department of Rheumatology and Immunology, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China
16
Department of Rheumatology and Immunology, The First People’s Hospital of Lianyungang, Lianyungang, Jiangsu, China
17
Department of Rheumatology and Immunology, Wuxi No. 2 People’s Hospital, Wuxi, Jiangsu, China
18
Department of Rheumatology and Immunology, The Affiliated Suqian First People’s Hospital of Nanjing Medical University, Suqian, Jiangsu, China
Submission date: 2023-09-04
Final revision date: 2024-01-17
Acceptance date: 2024-01-20
Online publication date: 2024-12-16
Corresponding author
Zhichun Liu
Department of Rheumatology and Immunology, Second Affiliated Hospital of Soochow University, Suzhou, 215004, China, China
Department of Rheumatology and Immunology, Second Affiliated Hospital of Soochow University, Suzhou, 215004, China, China
KEYWORDS
dermatomyositisanti-MDA5+ dermatomyositisrapidly progressive interstitial lung diseaseproximal muscle involvementheliotrope rashrisk factors
TOPICS
ABSTRACT
Introduction:
To identify the clinical characteristics and risk factors for cutaneous ulcers in patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+ DM) combined with rapidly progressive interstitial lung disease (RPILD).
Material and methods:
We conducted a retrospective cohort study on the medical records of patients enrolled from the Nanjing Medical University Myositis-associated ILD cohort (NMMI). The clinical characteristics of patients in the ulcer-positive group were compared with those in the ulcer-negative group by chi-square or Fisher’s exact test. Univariate and multivariate logistic regression analyses were used to assess risk factors for the development of cutaneous ulcers.
Results:
A total of 246 patients with anti-MDA5+ DM were retrospectively enrolled in the study, including 176 females (176/246, 71.54%) and 70 males (70/246, 28.46%), with a female-to-male ratio of 2.51 : 1. Among the 246 patients, a total of 88 cases (88/246, 35.77%) with anti-MDA5+ DM combined with RPILD were further studied, including 55 females (55/88, 62.5%) and 33 males (33/88, 37.5%), with a female-to-male ratio of 1.67 : 1. Twelve patients (12/88, 13.64%) had cutaneous ulcers. In terms of clinical characteristics, patients in the ulcer-positive group had significantly more proximal muscle involvement (83.33% vs. 38.16%, p = 0.003) and more heliotrope rash (83.33% vs. 43.42%, p = 0.010) than in the ulcer-negative group. In univariate analysis, cutaneous ulcers were associated with proximal muscle involvement (OR = 8.103; 95% CI: 1.657–39.625; p = 0.010) and heliotrope rash (OR = 6.515; 95% CI: 1.336–31.773; p = 0.020). In multivariate analysis, cutaneous ulcers were associated with proximal muscle involvement (OR = 6.436; 95% CI: 1.274–32.524; p = 0.024), and proximal muscle involvement was an independent risk factor for cutaneous ulcers.
Conclusions:
We confirmed the association between cutaneous ulcers and proximal muscle involvement and heliotrope rash in patients with anti-MDA5+ DM combined with RPILD. Proximal muscle involvement is an independent risk factor for cutaneous ulcers.
To identify the clinical characteristics and risk factors for cutaneous ulcers in patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+ DM) combined with rapidly progressive interstitial lung disease (RPILD).
Material and methods:
We conducted a retrospective cohort study on the medical records of patients enrolled from the Nanjing Medical University Myositis-associated ILD cohort (NMMI). The clinical characteristics of patients in the ulcer-positive group were compared with those in the ulcer-negative group by chi-square or Fisher’s exact test. Univariate and multivariate logistic regression analyses were used to assess risk factors for the development of cutaneous ulcers.
Results:
A total of 246 patients with anti-MDA5+ DM were retrospectively enrolled in the study, including 176 females (176/246, 71.54%) and 70 males (70/246, 28.46%), with a female-to-male ratio of 2.51 : 1. Among the 246 patients, a total of 88 cases (88/246, 35.77%) with anti-MDA5+ DM combined with RPILD were further studied, including 55 females (55/88, 62.5%) and 33 males (33/88, 37.5%), with a female-to-male ratio of 1.67 : 1. Twelve patients (12/88, 13.64%) had cutaneous ulcers. In terms of clinical characteristics, patients in the ulcer-positive group had significantly more proximal muscle involvement (83.33% vs. 38.16%, p = 0.003) and more heliotrope rash (83.33% vs. 43.42%, p = 0.010) than in the ulcer-negative group. In univariate analysis, cutaneous ulcers were associated with proximal muscle involvement (OR = 8.103; 95% CI: 1.657–39.625; p = 0.010) and heliotrope rash (OR = 6.515; 95% CI: 1.336–31.773; p = 0.020). In multivariate analysis, cutaneous ulcers were associated with proximal muscle involvement (OR = 6.436; 95% CI: 1.274–32.524; p = 0.024), and proximal muscle involvement was an independent risk factor for cutaneous ulcers.
Conclusions:
We confirmed the association between cutaneous ulcers and proximal muscle involvement and heliotrope rash in patients with anti-MDA5+ DM combined with RPILD. Proximal muscle involvement is an independent risk factor for cutaneous ulcers.
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| eISSN: | 1896-9151 |
| ISSN: | 1734-1922 |
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