A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin Ulcers
Tian Sun,1 Zhong Hao Hu,1 Jin Shi He,1 Yu Chi Chen,2 Yong Xiang Gao2 1Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of ChinaCorresponden...
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Dove Medical Press
2024-01-01
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| Series: | International Medical Case Reports Journal |
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| Online Access: | https://www.dovepress.com/a-case-of-dermatomyositis-with-coexistence-of-positive-anti-mda5-antib-peer-reviewed-fulltext-article-IMCRJ |
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| author | Sun T Hu ZH He JS Chen YC Gao YX |
| author_facet | Sun T Hu ZH He JS Chen YC Gao YX |
| author_sort | Sun T |
| collection | DOAJ |
| description | Tian Sun,1 Zhong Hao Hu,1 Jin Shi He,1 Yu Chi Chen,2 Yong Xiang Gao2 1Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of ChinaCorrespondence: Yu Chi Chen, Email 5301@cdutcm.edu.cn; Yong Xiang Gao, Email drgaoyx@cdutcm.edu.cnBackground: Dermatomyositis (DM) is an idiopathic inflammatory myopathy that is clinically challenging to diagnose and has a poor prognosis. It is characterized by symmetric proximal muscle weakness, muscle tenderness, dysphagia, characteristic skin rash (heliotrope rash, Gottron’s sign), elevated muscle enzyme levels, abnormal electromyography, and muscle biopsy findings. DM with positive anti-MDA5 antibodies is mainly characterized by Gottron’s sign, skin ulcers, facial erythema, mechanic’s hands, and V-sign. In this case, the patient presented with the rare manifestation of severe necrotic skin ulcers in association with Gottron’s sign, prompting us to report this case.Case Presentation: A 45-year-old female was admitted to the hospital with systemic joint pain, fatigue, multiple ulcers, and purulent discharge on both hands. Her myositis-specific antibody profile revealed positive anti-MDA5 and anti-SSA/RO52 antibodies. Treatment included a combination of glucocorticoids, immunosuppressants, gastric and liver protection, infection control, and wound care. After two weeks of treatment, the patient showed improvement in symptoms. However, on the 24th day of hospitalization, the wound at the right elbow joint ruptured and became infected, requiring debridement and skin grafting in the appropriate department.Conclusion: There has been limited research and reported cases of dermatomyositis with coexistence of positive anti-MDA5 and anti-SSA/RO52 antibodies combined with severe skin ulcers. Therefore, we present this rare case and emphasize the need for close follow-up on pulmonary involvement and skin ulcer progression, as well as timely implementation of new treatment strategies to actively improve the prognosis.Keywords: dermatomyositis, MDA5 antibodies, SSA/RO52 antibodies, immunosuppressants |
| first_indexed | 2024-03-08T16:10:45Z |
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| institution | Directory Open Access Journal |
| issn | 1179-142X |
| language | English |
| last_indexed | 2024-03-08T16:10:45Z |
| publishDate | 2024-01-01 |
| publisher | Dove Medical Press |
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| series | International Medical Case Reports Journal |
| spelling | doaj.art-b076a65e66d8481f8fdf133bb3b8f3432024-01-07T18:06:43ZengDove Medical PressInternational Medical Case Reports Journal1179-142X2024-01-01Volume 1791589551A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin UlcersSun THu ZHHe JSChen YCGao YXTian Sun,1 Zhong Hao Hu,1 Jin Shi He,1 Yu Chi Chen,2 Yong Xiang Gao2 1Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of ChinaCorrespondence: Yu Chi Chen, Email 5301@cdutcm.edu.cn; Yong Xiang Gao, Email drgaoyx@cdutcm.edu.cnBackground: Dermatomyositis (DM) is an idiopathic inflammatory myopathy that is clinically challenging to diagnose and has a poor prognosis. It is characterized by symmetric proximal muscle weakness, muscle tenderness, dysphagia, characteristic skin rash (heliotrope rash, Gottron’s sign), elevated muscle enzyme levels, abnormal electromyography, and muscle biopsy findings. DM with positive anti-MDA5 antibodies is mainly characterized by Gottron’s sign, skin ulcers, facial erythema, mechanic’s hands, and V-sign. In this case, the patient presented with the rare manifestation of severe necrotic skin ulcers in association with Gottron’s sign, prompting us to report this case.Case Presentation: A 45-year-old female was admitted to the hospital with systemic joint pain, fatigue, multiple ulcers, and purulent discharge on both hands. Her myositis-specific antibody profile revealed positive anti-MDA5 and anti-SSA/RO52 antibodies. Treatment included a combination of glucocorticoids, immunosuppressants, gastric and liver protection, infection control, and wound care. After two weeks of treatment, the patient showed improvement in symptoms. However, on the 24th day of hospitalization, the wound at the right elbow joint ruptured and became infected, requiring debridement and skin grafting in the appropriate department.Conclusion: There has been limited research and reported cases of dermatomyositis with coexistence of positive anti-MDA5 and anti-SSA/RO52 antibodies combined with severe skin ulcers. Therefore, we present this rare case and emphasize the need for close follow-up on pulmonary involvement and skin ulcer progression, as well as timely implementation of new treatment strategies to actively improve the prognosis.Keywords: dermatomyositis, MDA5 antibodies, SSA/RO52 antibodies, immunosuppressantshttps://www.dovepress.com/a-case-of-dermatomyositis-with-coexistence-of-positive-anti-mda5-antib-peer-reviewed-fulltext-article-IMCRJdermatomyositismda5 antibodiesssa/ro52 antibodiesimmunosuppressants. |
| spellingShingle | Sun T Hu ZH He JS Chen YC Gao YX A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin Ulcers International Medical Case Reports Journal dermatomyositis mda5 antibodies ssa/ro52 antibodies immunosuppressants. |
| title | A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin Ulcers |
| title_full | A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin Ulcers |
| title_fullStr | A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin Ulcers |
| title_full_unstemmed | A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin Ulcers |
| title_short | A Case of Dermatomyositis with Coexistence of Positive Anti-MDA5 Antibodies and Anti-SSA/RO52 Antibodies, Combined with Necrotic Skin Ulcers |
| title_sort | case of dermatomyositis with coexistence of positive anti mda5 antibodies and anti ssa ro52 antibodies combined with necrotic skin ulcers |
| topic | dermatomyositis mda5 antibodies ssa/ro52 antibodies immunosuppressants. |
| url | https://www.dovepress.com/a-case-of-dermatomyositis-with-coexistence-of-positive-anti-mda5-antib-peer-reviewed-fulltext-article-IMCRJ |
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