Table 1.
Clinical Variants of Dermatomyositis and their Associated Autoantibodies
Antibody | Cutaneous manifestations | Muscle manifestations | Pulmonary manifestations | Additional notes |
---|---|---|---|---|
Anti-Jo-138–41 (Also considered myositis specific auto-antibody) | • Mechanic’s hands | • Proximal muscle weakness | • ILD | • Anti-Jo1 in the setting of inflammatory arthritis, inflammatory myositis, mechanic’s hands, and ILD is known as “anti-synthetase syndrome” |
• Fever and Raynaud’s phenomenon may be additional features | ||||
Additional Anti-synthetase antibodies (PL-7, Pl-12, EJ, OJ, KS, ZO, YRS/HA)3,42 | • Mechanic’s hands | • May or may not have muscle involvement | • ILD | • Also associated with anti-synthetase syndrome, as noted above |
Anti-Mi-243,44 | • V-sign | • Proximal muscle weakness | • Typically spares lungs | • Lower risk of malignancy compared to other dermatomyositis patients |
• Shawl sign | ||||
• Gottron’s papules | ||||
• Heliotrope rash | ||||
• Steroid responsive45 | ||||
Anti-p140/MJ/NXP-246 | • Calcinosis leading to contractures | • Proximal muscle weakness | • High rates of ILD46 | • Higher rates of cancer especially in male patients47,48 |
• Younger age of onset | ||||
Anti-SAE49–51 | • V-sign | • Myositis often follows cutaneous symptoms49,52,53 | • Lower rates of ILD52 | • Dysphagia52,53 |
• Shawl sign | • If ILD present, tends to be mild and responsive to therapy53 | • Systemic symptoms (fever, weight loss)52 | ||
• Gottron’s papules | ||||
• Heliotrope rash | ||||
• Periungal erythema | ||||
Anti-TIF1-γ/p155-14054,55 | • V-sign | • May or may not have muscle involvement | • Lower rates of ILD | • Associated with malignancy4,56–58 |
• Shawl sign | ||||
• Gottron’s papules | ||||
• Hypopigmented patches with punctate telangiectasia or erythematous macules (“red on white” lesions) | ||||
Anti-MDA5/CADM1409 | • Heliotrope rash | • Often clinically amyopathic | • High rate of ILD16 | • Arthralgias, arthritis |
• Gottron’s papules | • Rapidly progressive disease | • Fever | ||
• Cutaneous ulceration | • Hoarseness, oral ulceration | |||
• Palmar papules | • Elevated serum ferritin8 | |||
• Mucosal pain | ||||
• Alopecia |