Dermatomyositis
Etiologia i przyczyny

Dermatomyositis (DM) to rzadka, autoimmunologiczna choroba zapalna charakteryzująca się osłabieniem mięśni i typową wysypką skórną. Patogeneza DM obejmuje nieprawidłową odpowiedź immunologiczną z atakiem na śródbłonek naczyń włosowatych mięśni i skóry, z aktywacją układu dopełniacza (rozszczepienie C3 do C3b i C4b). Genetyczne predyspozycje wiążą się z określonymi typami HLA (HLA-DR3, DR5, DR6, DR52), gdzie HLA-DRw52 koreluje z cięższą postacią choroby, a HLA-DRw53 z łagodniejszą. Polimorfizmy genu TNF-α, zwłaszcza allel -308A, są powiązane z fotowrażliwością i zwapnieniami u dzieci, a także opornym przebiegiem choroby. Czynniki infekcyjne, głównie wirusy (m.in. Coxsackie B, Parwowirus B19, EBV, HIV, HTLV-1, HBV, HCV), oraz bakterie i pasożyty mogą wyzwalać lub zaostrzać DM, szczególnie u osób genetycznie predysponowanych. Ekspozycja na promieniowanie UV oraz zanieczyszczenia powietrza również wpływają na rozwój i przebieg choroby.

  1. Etiologia Dermatomyositis
    1. Podłoże immunologiczne
    2. Predyspozycje genetyczne
    3. Czynniki infekcyjne
    4. Czynniki środowiskowe
    5. Leki jako czynniki wyzwalające dermatomyositis
    6. Związek z nowotworem
    7. Inne czynniki
  2. Podsumowanie etiologii Dermatomyositis
    1. Kolejne rozdziały

Etiologia Dermatomyositis

Dermatomyositis (DM) jest rzadką chorobą zapalną, która charakteryzuje się osłabieniem mięśni i charakterystyczną wysypką skórną. Mimo intensywnych badań, dokładna przyczyna dermatomyositis pozostaje nieznana. Naukowcy wskazują jednak na złożoną interakcję czynników genetycznych, immunologicznych i środowiskowych, które przyczyniają się do rozwoju tej choroby.12

Podłoże immunologiczne

Dermatomyositis wykazuje wiele cech typowych dla chorób autoimmunologicznych. Uważa się, że główny mechanizm patogenetyczny polega na nieprawidłowej odpowiedzi układu immunologicznego, w której dochodzi do ataku na własne tkanki organizmu, szczególnie na naczynia krwionośne zaopatrujące mięśnie i skórę.34 W dermatomyositis proces autoimmunologiczny prowadzi do zapalenia i uszkodzenia naczyń krwionośnych i tkanki łącznej, które zaopatrują i wspierają mięśnie oraz skórę.5

Jedna z teorii dotyczących mechanizmu leżącego u podstaw choroby wskazuje, że przeciwciała autoimmunologiczne atakują śródbłonek naczyń włosowatych w mięśniach, co uniemożliwia dostarczanie do tkanek krwi bogatej w tlen i składniki odżywcze.6 Badania wykazały, że dermatomyositis jest pośredniczone przez aktywację układu dopełniacza, w tym rozszczepienie C3 do C3b i C4b, które są odkładane w naczyniach włosowatych mięśni i śródbłonku tętniczek.7

U pacjentów z dermatomyositis często wykrywa się krążące autoprzeciwciała, chociaż nie jest jasne, czy odgrywają one rolę w patogenezie choroby.8 Większość pacjentów ma autoprzeciwciała związane z chorobą, co sugeruje autoimmunologiczny charakter dermatomyositis.9

Predyspozycje genetyczne

Czynniki genetyczne mogą predysponować do rozwoju dermatomyositis. Chociaż choroba rzadko występuje u wielu członków rodziny, istnieje powiązanie z pewnymi typami ludzkich antygenów leukocytarnych (HLA).10 Badania wskazują na zwiększone ryzyko zachorowania u osób z określonymi typami HLA, takimi jak:1112

  • HLA-DR3
  • HLA-DR5
  • HLA-DR6
  • HLA-DR52

1314

Związek między dermatomyositis a podtypami HLA jest na tyle znaczący, że chorobę sklasyfikowano na dwie główne grupy immunogenetyczne:15

  • Grupa HLA-DRw52, związana z cięższą postacią zapalenia mięśni i gorszym rokowaniem
  • Grupa HLA-DRw53, związana z łagodniejszą postacią zapalenia mięśni i lepszym rokowaniem

16

Oprócz typów HLA, z dermatomyositis mogą być związane również polimorfizmy czynnika martwicy nowotworów (TNF). W szczególności obecność allelu -308A jest powiązana z fotowrażliwością u dorosłych i zwapnieniami u dzieci.17 U dzieci, polimorfizm genu TNF-alfa-308 (substytucja A na G w regionie promotora) jest związany z przedłużonym, opornym na leczenie przebiegiem choroby.18

Inne geny, takie jak PTPN22, również zostały zidentyfikowane jako potencjalnie zwiększające podatność na rozwój dermatomyositis.19 Badania sugerują także, że warianty genów związanych z odpowiedzią zapalną mogą wpływać na manifestację dermatomyositis.20

Czynniki infekcyjne

Czynniki infekcyjne, szczególnie wirusy, są podejrzewane o rolę wyzwalaczy dermatomyositis. U osób genetycznie predysponowanych, infekcje wirusowe, bakteryjne i pasożytnicze mogą indukować autoimmunizację, a nawet zaostrzać istniejące stany autoimmunologiczne.21

Wirusy najczęściej wiązane z dermatomyositis to:222324

252627

Niektóre z tych wirusów, takie jak HIV i HTLV, mają dobrze ustaloną relację z zaburzeniami mięśni, a zakażenie tymi czynnikami może wywołać odpowiedzi immunologiczne, które nakładają się na objawy dermatomyositis.28 U dzieci z młodzieńczym dermatomyositis (JDM) zaobserwowano sezonowe występowanie choroby, szczególnie w miesiącach kwietniu i maju, co sugeruje rolę czynników środowiskowych w wystąpieniu lub zaostrzeniu choroby.29

Badacze znaleźli, że limfocyty T układu immunologicznego u niektórych pacjentów z polymyositis lub dermatomyositis reagowały przeciwko cytomegalowirusowi (CMV) i wykryto przeciwciała przeciwko CMV. Ich wniosek był taki, że mogą istnieć podgrupy pacjentów, którzy rozwijają swoją chorobę, częściowo, z powodu zakażenia tym konkretnym wirusem.30

Oprócz wirusów, w patogenezie dermatomyositis podejrzewane są również bakterie i pasożyty. Badanie kontrolne wykazało zwiększoną częstość zakażeń paciorkowcowych u osób z JDM w porównaniu z dopasowanymi kontrolami.31 Wśród innych patogenów wymienia się Toxoplasma i Borrelia.32

Zgłoszono również nowe przypadki dermatomyositis po zakażeniu COVID-19 lub szczepieniu przeciwko tej chorobie.3334

Czynniki środowiskowe

Różne czynniki środowiskowe mogą przyczyniać się do rozwoju dermatomyositis u osób genetycznie predysponowanych:35

Promieniowanie ultrafioletowe (UV)

Skórne cechy dermatomyositis, w tym uporczywy rumień, zwiększona częstość występowania w miejscach narażonych na działanie słońca i fotoagrawacja, sugerują, że promieniowanie UV odgrywa istotną rolę w patogenezie choroby.36 Częstość występowania dermatomyositis znacznie wzrasta wraz ze zmniejszającym się położeniem geograficznym od północnej Europy do południowej Europy, co sugeruje, że ekspozycja na promieniowanie UV może być powiązana z patogenezą DM.37

Badanie, które badało związek między ekspozycją na promieniowanie ultrafioletowe (UVR) a kliniczną i autoprzeciwciałową ekspresją młodzieńczych idiopatycznych miopatii zapalnych (IIM), wykazało, że krótkotrwała ekspozycja na UVR przed wystąpieniem choroby może odgrywać rolę w klinicznej i serologicznej ekspresji młodzieńczego zapalenia mięśni.38

Zaobserwowano, że dermatomyositis występuje częściej wśród kobiet narażonych na promieniowanie ultrafioletowe o wysokiej intensywności.3940 W krajach lub regionach, gdzie występuje większe promieniowanie ultrafioletowe i wysoka ekspozycja na słońce, występuje wyższa częstość dermatomyositis.41

Zanieczyszczenie powietrza

Badania wykazały, że życie w obszarach o wyższym zanieczyszczeniu lub niższej jakości powietrza może zwiększać prawdopodobieństwo rozwoju dermatomyositis.42 Zwiększone stężenie cząstek stałych w powietrzu, na przykład z emisji pojazdów i przemysłowych, jest związane ze zwiększoną śmiertelnością.43

Badanie kontrolne wykazało związek między wdychanymi zanieczyszczeniami i paleniem tytoniu podczas rozwoju płodowego a młodzieńczym dermatomyositis.44 Ponadto, zaproponowano związek z wysokim zanieczyszczeniem powietrza w amiopatycznym dermatomyositis.45

Leki jako czynniki wyzwalające dermatomyositis

Dermatomyositis może być wywołane przez niektóre leki. Wiele leków zostało powiązanych z wystąpieniem lub zaostrzeniem dermatomyositis.4647

Najczęstszą przyczyną polekowego dermatomyositis jest hydroksymocznik, związany z 50% przypadków zgłoszonych w literaturze medycznej i dotykający do 4% pacjentów przyjmujących ten lek.48 W przeglądzie 70 przypadków przeprowadzonym przez Seidlera i Gottlieba, hydroksymocznik był najczęstszą przyczyną polekowego dermatomyositis, stanowiąc 51% przypadków.49

Inne leki zgłaszane jako wyzwalacze dermatomyositis to:505152

  • Penicylamina
  • Leki obniżające poziom lipidów, w tym statyny i inhibitory HMF-CoA reduktazy
  • Cyklofosfamid
  • Niesteroidowe leki przeciwzapalne
  • Leki przeciwdrgawkowe
  • Szczepionka BCG (Bacillus Calmette-Guérin) i inne szczepienia
  • Inhibitory punktów kontrolnych układu immunologicznego
  • Inhibitory TNF (czynnika martwicy nowotworów)
  • Chinidyna
  • Interferon

5354

Inhibitory TNF-α, takie jak infliksymab, adalimumab i etanercept, są często stosowane w leczeniu wielu chorób autoimmunologicznych i reumatologicznych, takich jak łuszczyca, reumatoidalne zapalenie stawów, zesztywniające zapalenie stawów kręgosłupa i choroba Crohna.55

Inhibitory punktów kontrolnych układu immunologicznego (ICI) mają na celu wzmocnienie zdolności układu immunologicznego do rozpoznawania i niszczenia komórek nowotworowych. Jednak zdarzenia niepożądane związane z autoimmunizacją, w tym autoimmunologiczne choroby skóry, takie jak dermatomyositis, są coraz częściej wiązane z ICI z powodu zwiększonej aktywacji limfocytów T przeciwnowotworowych i niespecyficznej blokady tolerancji na własne antygeny.56

Dermatomyositis-podobne zmiany skórne zgłaszano przy stosowaniu hydroksymocznika u pacjentów z przewlekłą białaczką szpikową lub samoistną trombocytozą.57 Dermatomyositis może być również inicjowane lub zaostrzane przez implanty piersi silikonowe lub iniekcje kolagenu, ale dowody na to są anegdotyczne i nie zostały zweryfikowane w badaniach kontrolnych.58

Związek z nowotworem

Jedną z najważniejszych cech dermatomyositis jest jego powiązanie z nowotworami. Dermatomyositis może rozwinąć się jako zespół paranowotworowy związany z kilkoma formami nowotworów.59

Około 15-30% przypadków dermatomyositis u dorosłych jest związanych ze złośliwością, taką jak rak piersi, jajnika lub płuc. Jest to znane jako paraneoplastyczne dermatomyositis, co oznacza, że choroba jest powiązana, ale nie bezpośrednio związana z guzem.60 Niektóre badania sugerują 6,5-krotnie zwiększone ryzyko złośliwości.61

Najczęściej zgłaszane nowotwory to:626364

  • Rak jajnika
  • Rak żołądka
  • Chłoniak
  • Rak płuc
  • Rak piersi
  • Rak trzustki
  • Nowotwory hematologiczne
  • Rak nosogardzieli (wśród populacji azjatyckich)

656667

Warto zauważyć, że zmiany skórne nie różnią się u pacjentów z nowotworem lub bez. Dlatego staranne badanie w kierunku nowotworu powinno być rozpoczęte w momencie zdiagnozowania dermatomyositis.68 Główne przyczyny śmierci związane z tym schorzeniem to nowotwór i choroba płuc.6970

U dorosłych z dermatomyositis istnieje silny związek z nowotworem; do 25% dotkniętych dorosłych ma nieznany nowotwór w momencie diagnozy. Większość to gruczolakoraki.71 Jednak ważne jest, aby zauważyć, że zwiększone ryzyko nowotworu nie zostało powiązane z młodzieńczym dermatomyositis.72

Inne czynniki

Dermatomyositis może być związane z innymi chorobami autoimmunologicznymi takimi jak zapalenie tarczycy Hashimoto, twardzina układowa i makroglobulinemia Waldenströma.73 Ekspozycja na różne czynniki podczas ciąży, takie jak ekspozycja na antygeny płodowe, zmiany w statusie hormonalnym matki i reaktywacja niektórych wirusów przez ciążę, były rozważane jako wyzwalacze rozwoju dermatomyositis.74

Dodatkowo, niektóre suplementy ziołowe, w tym Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, jeżówka i lucerna, stymulują układ immunologiczny, a ich stosowanie było związane z zaostrzeniami autoimmunologicznych chorób skóry, a nawet początkiem choroby.75

Podsumowanie etiologii Dermatomyositis

Dermatomyositis jest złożoną chorobą o wieloczynnikowej etiologii. Chociaż dokładna przyczyna pozostaje nieznana, rośnie zrozumienie czynników przyczyniających się do jej rozwoju. Wykazano, że czynniki genetyczne, immunologiczne i środowiskowe odgrywają rolę w patogenezie. Związek z nowotworem, szczególnie u dorosłych, podkreśla potrzebę dokładnego badania przy diagnozie.

Badania nad przyczynami i mechanizmami dermatomyositis trwają, a przyszłe odkrycia mogą prowadzić do lepszego zrozumienia i bardziej ukierunkowanych opcji leczenia dla pacjentów z tą rzadką, ale poważną chorobą.

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  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Dermatomyositis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK558917/
    Dermatomyositis is a rare acquired immune-mediated muscle disease characterized by muscle weakness and skin rash. Although the cause of dermatomyositis is unknown, several genetic, immunologic, and environmental factors are implicated in this condition. […] Multiple studies have indicated that patients with particular human leukocyte antigen (HLA) types are at higher risk of dermatomyositis. […] Although autoantibodies are detected in patients with dermatomyositis, it is unclear whether they play a role in pathogenesis. […] Viruses such as Coxsackie B virus, enterovirus, and parvovirus have been suspected of acting as triggers of dermatomyositis. […] Several drugs can trigger dermatomyositis. […] Dermatomyositis has been observed to occur more frequently among women exposed to high-intensity ultraviolet radiation.
  • #2 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    The cause of dermatomyositis is unknown. However, genetic, immunologic, infectious, and environmental factors have been implicated. […] A genetic component may predispose to dermatomyositis. Dermatomyositis rarely occurs in multiple family members, but a link to certain human leukocyte antigen (HLA) types (eg, DR3, DR5, DR7) may exist. […] Polymorphisms of tumor necrosis factor (TNF) may be involved; specifically, the presence of the -308A allele is linked to photosensitivity in adults and calcinosis in children. […] Immunologic abnormalities are common in patients with dermatomyositis. Patients frequently have circulating autoantibodies. […] Infectious agents have been suggested as possible triggers of dermatomyositis. These include the following: viruses (eg, coxsackievirus, parvovirus, echovirus, human T-cell lymphotropic virus type 1 [HTLV-1], HIV), Toxoplasma species, Borrelia species.
  • #3 Dermatomyositis – Diseases | Muscular Dystrophy Association
    https://www.mda.org/disease/dermatomyositis
    In most cases, the cause of an IIM is unclear. For some reason, the bodys immune system turns against its own muscles and damages muscle tissue in an autoimmune process. In dermatomyositis, these cells attack the small blood vessels that supply muscles and skin. […] Dermatomyositis is not a genetic disorder, although there may be genetic factors that make it more or less likely that an inflammatory myopathy will develop.
  • #4 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Dermatomyositis-Causes.aspx
    The exact cause of dermatomyositis is not clearly understood, although the condition shares many characteristics with autoimmune disorders such as lupus, scleroderma, and vasculitis. […] Therefore, an unknown factor may trigger the production of autoimmune antibodies that then attack the body’s tissues. One theory regarding the underlying mechanism of the disease is that autoantibodies target the endothelium of capillaries in the muscles which prevents the supply of oxygenated and nutrient-rich blood to the tissues. […] It has been observed in some cases that people with dermatomyositis have also previously been diagnosed with other types of infection such as Epstein-Barr virus, chlamydia or mononucleosis. […] Dermatomyositis may also occur as paraneoplastic syndrome. This means the condition may occur as a consequence of the presence of cancer, which can itself cause abnormal inflammatory reactions and the release of several immune mediators in the body. […] Due to the high risk of cancer in dermatomyositis patients, physicians will often run tests to check for cancer in these individuals.
  • #5 Causes/Inheritance – Dermatomyositis – Diseases | Muscular Dystrophy Association
    https://www.mda.org/disease/dermatomyositis/causes-inheritance
    In most cases, the cause of the idiopathic inflammatory myopathies (IIMs), the disease group that encompasses dermatomyositis, is unclear. For some reason, the bodys immune system turns against its own tissues in an autoimmune process. In dermatomyositis, the autoimmune process causes inflammation and damage in the blood vessels and connective tissues that supply and support muscles and skin. […] A combination of genetic, immune, and environmental factors is thought to contribute to development of the IIMs. Some environmental triggers that have been associated with dermatomyositis include viral infection, certain medications, and sun exposure.
  • #6 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Dermatomyositis-Causes.aspx
    The exact cause of dermatomyositis is not clearly understood, although the condition shares many characteristics with autoimmune disorders such as lupus, scleroderma, and vasculitis. […] Therefore, an unknown factor may trigger the production of autoimmune antibodies that then attack the body’s tissues. One theory regarding the underlying mechanism of the disease is that autoantibodies target the endothelium of capillaries in the muscles which prevents the supply of oxygenated and nutrient-rich blood to the tissues. […] It has been observed in some cases that people with dermatomyositis have also previously been diagnosed with other types of infection such as Epstein-Barr virus, chlamydia or mononucleosis. […] Dermatomyositis may also occur as paraneoplastic syndrome. This means the condition may occur as a consequence of the presence of cancer, which can itself cause abnormal inflammatory reactions and the release of several immune mediators in the body. […] Due to the high risk of cancer in dermatomyositis patients, physicians will often run tests to check for cancer in these individuals.
  • #7 Dermatomyositis – EyeWiki
    https://eyewiki.org/Dermatomyositis
    In addition, DM may present secondary to paraneoplastic syndromes in breast cancer and other malignancies. […] Risk factors, apart from genetic and environmental etiological factors mentioned above, are not well characterized. […] A case-control study found an association between inhaled pollutants and tobacco smoking during fetal development and juvenile DM. […] An association with high airborne pollution has been proposed in amyopathic DM. […] A higher prevalence of DM was noted in Southern Europe compared to Northern Europe and may be due to the increased exposure to UV-B light, other environmental factors, or differences in genetic background. […] DM is believed to be mediated by C3 cleavage to form C3b and C4b, which activates complement, which is deposited in muscle capillaries and the endothelium of arterioles. […] DM is an idiopathic, microangiopathic myopathy characterized by muscle weakness, Gottron papules and heliotrope rashes, and has a multi-factorial pathogenesis with multiple genetic, immunologic, and environmental factors that contribute.
  • #8 Dermatomyositis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK558917/
    Dermatomyositis is a rare acquired immune-mediated muscle disease characterized by muscle weakness and skin rash. Although the cause of dermatomyositis is unknown, several genetic, immunologic, and environmental factors are implicated in this condition. […] Multiple studies have indicated that patients with particular human leukocyte antigen (HLA) types are at higher risk of dermatomyositis. […] Although autoantibodies are detected in patients with dermatomyositis, it is unclear whether they play a role in pathogenesis. […] Viruses such as Coxsackie B virus, enterovirus, and parvovirus have been suspected of acting as triggers of dermatomyositis. […] Several drugs can trigger dermatomyositis. […] Dermatomyositis has been observed to occur more frequently among women exposed to high-intensity ultraviolet radiation.
  • #9 Adult-onset dermatomyositis
    https://dermnetnz.org/topics/adult-onset-dermatomyositis
    Dermatomyositis is thought to be caused by a microangiopathy affecting skin and muscle. There is a genetic predisposition to the development of dermatomyositis such as the PTPN22 gene and HLA associations identified include: […] Triggers and reported associations have included: […] Most patients have disease-associated autoantibodies, suggesting dermatomyositis is an autoimmune condition. […] Adult-onset dermatomyositis is strongly associated with malignancy; up to 25% of affected adults have an unknown underlying malignancy on diagnosis. The majority are adenocarcinomas.
  • #10 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    The cause of dermatomyositis is unknown. However, genetic, immunologic, infectious, and environmental factors have been implicated. […] A genetic component may predispose to dermatomyositis. Dermatomyositis rarely occurs in multiple family members, but a link to certain human leukocyte antigen (HLA) types (eg, DR3, DR5, DR7) may exist. […] Polymorphisms of tumor necrosis factor (TNF) may be involved; specifically, the presence of the -308A allele is linked to photosensitivity in adults and calcinosis in children. […] Immunologic abnormalities are common in patients with dermatomyositis. Patients frequently have circulating autoantibodies. […] Infectious agents have been suggested as possible triggers of dermatomyositis. These include the following: viruses (eg, coxsackievirus, parvovirus, echovirus, human T-cell lymphotropic virus type 1 [HTLV-1], HIV), Toxoplasma species, Borrelia species.
  • #11 Dermatomyositis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK558917/
    Dermatomyositis is a rare acquired immune-mediated muscle disease characterized by muscle weakness and skin rash. Although the cause of dermatomyositis is unknown, several genetic, immunologic, and environmental factors are implicated in this condition. […] Multiple studies have indicated that patients with particular human leukocyte antigen (HLA) types are at higher risk of dermatomyositis. […] Although autoantibodies are detected in patients with dermatomyositis, it is unclear whether they play a role in pathogenesis. […] Viruses such as Coxsackie B virus, enterovirus, and parvovirus have been suspected of acting as triggers of dermatomyositis. […] Several drugs can trigger dermatomyositis. […] Dermatomyositis has been observed to occur more frequently among women exposed to high-intensity ultraviolet radiation.
  • #12 Dermatomyositis – Wikipedia
    https://en.wikipedia.org/wiki/Dermatomyositis
    Dermatomyositis may develop as a paraneoplastic syndrome associated with several forms of malignancy. […] It is known to be associated with several viruses, especially coxsackievirus, but no definitive causal link has been found. […] The pathogenesis of dermatomyositis involves an autoimmune-mediated process characterized by immune complex deposition and complement activation, leading to microangiopathy in both muscle and skin tissues. […] As many as 40% of cases of dermatomyositis are paraneoplastic manifestations of an underlying cancer. […] The most commonly associated cancers are ovarian cancer, breast cancer, and lung cancer overall, but the most frequent associations can vary depending on patient race or ethnicity. […] Inherited genetic factors play at least a partial role in developing the disease, and HLA subtypes HLA-DR3, HLA-DR52, and HLA-DR6 seem to create a disposition to autoimmune dermatomyositis.
  • #13 Adult-onset dermatomyositis
    https://dermnetnz.org/topics/adult-onset-dermatomyositis
    Dermatomyositis is thought to be caused by a microangiopathy affecting skin and muscle. There is a genetic predisposition to the development of dermatomyositis such as the PTPN22 gene and HLA associations identified include: […] Triggers and reported associations have included: […] Most patients have disease-associated autoantibodies, suggesting dermatomyositis is an autoimmune condition. […] Adult-onset dermatomyositis is strongly associated with malignancy; up to 25% of affected adults have an unknown underlying malignancy on diagnosis. The majority are adenocarcinomas.
  • #14 Dermatomyositis – Wikipedia
    https://en.wikipedia.org/wiki/Dermatomyositis
    Dermatomyositis may develop as a paraneoplastic syndrome associated with several forms of malignancy. […] It is known to be associated with several viruses, especially coxsackievirus, but no definitive causal link has been found. […] The pathogenesis of dermatomyositis involves an autoimmune-mediated process characterized by immune complex deposition and complement activation, leading to microangiopathy in both muscle and skin tissues. […] As many as 40% of cases of dermatomyositis are paraneoplastic manifestations of an underlying cancer. […] The most commonly associated cancers are ovarian cancer, breast cancer, and lung cancer overall, but the most frequent associations can vary depending on patient race or ethnicity. […] Inherited genetic factors play at least a partial role in developing the disease, and HLA subtypes HLA-DR3, HLA-DR52, and HLA-DR6 seem to create a disposition to autoimmune dermatomyositis.
  • #15 Dermatomyositis: symptoms, diagnosis and treatment
    https://www.synlab-sd.com/en/blog/health-and-wellness-en/dermatomyositis-its-relationship-with-immunity-and-the-advancement-of-clinical-analysis/
    The association between dermatomyositis and HLA subtypes is so significant that the disease has been classified into two major immunogenetic groups: the HLA-DRw52 group, associated with a more severe form of myositis and poorer prognosis, and the HLA-DRw53 group, linked to a milder form of myositis with a better prognosis. […] In addition to HLA subtypes, studies suggest that other genetic factors, such as variants in genes related to inflammatory response, may also influence the manifestation of dermatomyositis. […] Several viruses have been implicated in activating the immune system and developing inflammatory responses in muscles, which characterize the disease. […] Among the viruses frequently associated with DM are: Influenza A, Hepatitis B, Coxsackie virus, Echovirus, HIV (Human Immunodeficiency Virus), HTLV (Human T-lymphotropic Virus), Picornaviruses.
  • #16 Dermatomyositis: symptoms, diagnosis and treatment
    https://www.synlab-sd.com/en/blog/health-and-wellness-en/dermatomyositis-its-relationship-with-immunity-and-the-advancement-of-clinical-analysis/
    The association between dermatomyositis and HLA subtypes is so significant that the disease has been classified into two major immunogenetic groups: the HLA-DRw52 group, associated with a more severe form of myositis and poorer prognosis, and the HLA-DRw53 group, linked to a milder form of myositis with a better prognosis. […] In addition to HLA subtypes, studies suggest that other genetic factors, such as variants in genes related to inflammatory response, may also influence the manifestation of dermatomyositis. […] Several viruses have been implicated in activating the immune system and developing inflammatory responses in muscles, which characterize the disease. […] Among the viruses frequently associated with DM are: Influenza A, Hepatitis B, Coxsackie virus, Echovirus, HIV (Human Immunodeficiency Virus), HTLV (Human T-lymphotropic Virus), Picornaviruses.
  • #17 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    The cause of dermatomyositis is unknown. However, genetic, immunologic, infectious, and environmental factors have been implicated. […] A genetic component may predispose to dermatomyositis. Dermatomyositis rarely occurs in multiple family members, but a link to certain human leukocyte antigen (HLA) types (eg, DR3, DR5, DR7) may exist. […] Polymorphisms of tumor necrosis factor (TNF) may be involved; specifically, the presence of the -308A allele is linked to photosensitivity in adults and calcinosis in children. […] Immunologic abnormalities are common in patients with dermatomyositis. Patients frequently have circulating autoantibodies. […] Infectious agents have been suggested as possible triggers of dermatomyositis. These include the following: viruses (eg, coxsackievirus, parvovirus, echovirus, human T-cell lymphotropic virus type 1 [HTLV-1], HIV), Toxoplasma species, Borrelia species.
  • #18 Juvenile Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/1417215-overview
    Type I interferon-alpha/beta genes are overexpressed in dermatomyositis. […] Noninfectious agents implicated in the onset of JDM include D-penicillamine, vaccinations, and bone marrow transplants. […] Patients with human leukocyte antigen DQA1*0501 (HLA-DQA1*0501) have an increased susceptibility to JDM, in a strong linkage disequilibrium to HLA-DR3, compared with age-matched controls in white, black, and Hispanic children. […] Cytokine polymorphisms (eg, the substitution of A to G in the promoter region of tumor necrosis factor [TNF]alpha-308 allele) is associated with a prolonged, refractory course. […] A study that investigated the association between ultraviolet radiation (UVR) exposure and the clinical and autoantibody expression of juvenile idiopathic inflammatory myopathies (IIM) found that short-term UVR exposure prior to illness onset may have a role in the clinical and serologic expression of juvenile myositis. Further research examining the mechanisms of action of UVR in the pathogenesis of juvenile IIM is needed.
  • #19 Adult-onset dermatomyositis
    https://dermnetnz.org/topics/adult-onset-dermatomyositis
    Dermatomyositis is thought to be caused by a microangiopathy affecting skin and muscle. There is a genetic predisposition to the development of dermatomyositis such as the PTPN22 gene and HLA associations identified include: […] Triggers and reported associations have included: […] Most patients have disease-associated autoantibodies, suggesting dermatomyositis is an autoimmune condition. […] Adult-onset dermatomyositis is strongly associated with malignancy; up to 25% of affected adults have an unknown underlying malignancy on diagnosis. The majority are adenocarcinomas.
  • #20 Dermatomyositis: symptoms, diagnosis and treatment
    https://www.synlab-sd.com/en/blog/health-and-wellness-en/dermatomyositis-its-relationship-with-immunity-and-the-advancement-of-clinical-analysis/
    The association between dermatomyositis and HLA subtypes is so significant that the disease has been classified into two major immunogenetic groups: the HLA-DRw52 group, associated with a more severe form of myositis and poorer prognosis, and the HLA-DRw53 group, linked to a milder form of myositis with a better prognosis. […] In addition to HLA subtypes, studies suggest that other genetic factors, such as variants in genes related to inflammatory response, may also influence the manifestation of dermatomyositis. […] Several viruses have been implicated in activating the immune system and developing inflammatory responses in muscles, which characterize the disease. […] Among the viruses frequently associated with DM are: Influenza A, Hepatitis B, Coxsackie virus, Echovirus, HIV (Human Immunodeficiency Virus), HTLV (Human T-lymphotropic Virus), Picornaviruses.
  • #21 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    In genetically susceptible individuals, viral, bacterial, and parasitic infections have been suspected to induce autoimmunity and even exacerbate existing autoimmune conditions. […] The relationship of infection to DM onset has been better evaluated in children. […] Parvovirus B19 has been implicated in the pathogenesis of connective tissue diseases such as JDM. […] Coxsackie viruses are enteroviruses of the family Picornaviridae. […] Human polyomavirus (HPyV) 6 and HPyV7 are closely related polyomavirus species and are thought to infect the skin of many healthy individuals in a latent or subclinical manner. […] EBV has been linked to the development of a number of autoimmune disorders. […] HBV and HCV are viruses that can cause liver inflammation and damage. […] The occurrence of DM has also been reported in the setting of HIV infection. […] A case-control study found increased frequency of streptococcal infection in those with JDM than in matched controls.
  • #22 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    The cause of dermatomyositis is unknown. However, genetic, immunologic, infectious, and environmental factors have been implicated. […] A genetic component may predispose to dermatomyositis. Dermatomyositis rarely occurs in multiple family members, but a link to certain human leukocyte antigen (HLA) types (eg, DR3, DR5, DR7) may exist. […] Polymorphisms of tumor necrosis factor (TNF) may be involved; specifically, the presence of the -308A allele is linked to photosensitivity in adults and calcinosis in children. […] Immunologic abnormalities are common in patients with dermatomyositis. Patients frequently have circulating autoantibodies. […] Infectious agents have been suggested as possible triggers of dermatomyositis. These include the following: viruses (eg, coxsackievirus, parvovirus, echovirus, human T-cell lymphotropic virus type 1 [HTLV-1], HIV), Toxoplasma species, Borrelia species.
  • #23 Dermatomyositis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK558917/
    Dermatomyositis is a rare acquired immune-mediated muscle disease characterized by muscle weakness and skin rash. Although the cause of dermatomyositis is unknown, several genetic, immunologic, and environmental factors are implicated in this condition. […] Multiple studies have indicated that patients with particular human leukocyte antigen (HLA) types are at higher risk of dermatomyositis. […] Although autoantibodies are detected in patients with dermatomyositis, it is unclear whether they play a role in pathogenesis. […] Viruses such as Coxsackie B virus, enterovirus, and parvovirus have been suspected of acting as triggers of dermatomyositis. […] Several drugs can trigger dermatomyositis. […] Dermatomyositis has been observed to occur more frequently among women exposed to high-intensity ultraviolet radiation.
  • #24 Dermatomyositis: symptoms, diagnosis and treatment
    https://www.synlab-sd.com/en/blog/health-and-wellness-en/dermatomyositis-its-relationship-with-immunity-and-the-advancement-of-clinical-analysis/
    The association between dermatomyositis and HLA subtypes is so significant that the disease has been classified into two major immunogenetic groups: the HLA-DRw52 group, associated with a more severe form of myositis and poorer prognosis, and the HLA-DRw53 group, linked to a milder form of myositis with a better prognosis. […] In addition to HLA subtypes, studies suggest that other genetic factors, such as variants in genes related to inflammatory response, may also influence the manifestation of dermatomyositis. […] Several viruses have been implicated in activating the immune system and developing inflammatory responses in muscles, which characterize the disease. […] Among the viruses frequently associated with DM are: Influenza A, Hepatitis B, Coxsackie virus, Echovirus, HIV (Human Immunodeficiency Virus), HTLV (Human T-lymphotropic Virus), Picornaviruses.
  • #25 Juvenile Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/1417215-overview
    The etiology of JDM is incompletely understood. Evidence suggests a complex interplay of the innate and adaptive immune systems with environmental triggers in a genetically susceptible host. […] Seasonal clustering of JDM in the months of April and May suggests the role of environmental triggers in the onset or exacerbation of the disease. Infectious agents include viruses, parasites, and bacterial antigens that may produce a break in self-tolerance. Infectious agents implicated include the following: Coxsackie B virus, Parvovirus B19, Enteroviruses, Streptococcus species. […] New cases of dermatomyositis have been reported following COVID-19 infection or vaccination. […] Several mechanisms for infection-triggered autoimmunity have been proposed, including molecular mimicry, induction of anti-idiotypic antibodies, and modification of self-antigens through microbial proteins.
  • #26 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    In genetically susceptible individuals, viral, bacterial, and parasitic infections have been suspected to induce autoimmunity and even exacerbate existing autoimmune conditions. […] The relationship of infection to DM onset has been better evaluated in children. […] Parvovirus B19 has been implicated in the pathogenesis of connective tissue diseases such as JDM. […] Coxsackie viruses are enteroviruses of the family Picornaviridae. […] Human polyomavirus (HPyV) 6 and HPyV7 are closely related polyomavirus species and are thought to infect the skin of many healthy individuals in a latent or subclinical manner. […] EBV has been linked to the development of a number of autoimmune disorders. […] HBV and HCV are viruses that can cause liver inflammation and damage. […] The occurrence of DM has also been reported in the setting of HIV infection. […] A case-control study found increased frequency of streptococcal infection in those with JDM than in matched controls.
  • #27 Dermatomyositis: symptoms, diagnosis and treatment
    https://www.synlab-sd.com/en/blog/health-and-wellness-en/dermatomyositis-its-relationship-with-immunity-and-the-advancement-of-clinical-analysis/
    The association between dermatomyositis and HLA subtypes is so significant that the disease has been classified into two major immunogenetic groups: the HLA-DRw52 group, associated with a more severe form of myositis and poorer prognosis, and the HLA-DRw53 group, linked to a milder form of myositis with a better prognosis. […] In addition to HLA subtypes, studies suggest that other genetic factors, such as variants in genes related to inflammatory response, may also influence the manifestation of dermatomyositis. […] Several viruses have been implicated in activating the immune system and developing inflammatory responses in muscles, which characterize the disease. […] Among the viruses frequently associated with DM are: Influenza A, Hepatitis B, Coxsackie virus, Echovirus, HIV (Human Immunodeficiency Virus), HTLV (Human T-lymphotropic Virus), Picornaviruses.
  • #28 Dermatomyositis: symptoms, diagnosis and treatment
    https://www.synlab-sd.com/en/blog/health-and-wellness-en/dermatomyositis-its-relationship-with-immunity-and-the-advancement-of-clinical-analysis/
    The association between dermatomyositis and HLA subtypes is so significant that the disease has been classified into two major immunogenetic groups: the HLA-DRw52 group, associated with a more severe form of myositis and poorer prognosis, and the HLA-DRw53 group, linked to a milder form of myositis with a better prognosis. […] In addition to HLA subtypes, studies suggest that other genetic factors, such as variants in genes related to inflammatory response, may also influence the manifestation of dermatomyositis. […] Several viruses have been implicated in activating the immune system and developing inflammatory responses in muscles, which characterize the disease. […] Among the viruses frequently associated with DM are: Influenza A, Hepatitis B, Coxsackie virus, Echovirus, HIV (Human Immunodeficiency Virus), HTLV (Human T-lymphotropic Virus), Picornaviruses.
  • #29 Juvenile Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/1417215-overview
    The etiology of JDM is incompletely understood. Evidence suggests a complex interplay of the innate and adaptive immune systems with environmental triggers in a genetically susceptible host. […] Seasonal clustering of JDM in the months of April and May suggests the role of environmental triggers in the onset or exacerbation of the disease. Infectious agents include viruses, parasites, and bacterial antigens that may produce a break in self-tolerance. Infectious agents implicated include the following: Coxsackie B virus, Parvovirus B19, Enteroviruses, Streptococcus species. […] New cases of dermatomyositis have been reported following COVID-19 infection or vaccination. […] Several mechanisms for infection-triggered autoimmunity have been proposed, including molecular mimicry, induction of anti-idiotypic antibodies, and modification of self-antigens through microbial proteins.
  • #30 Polymyositis and Dermatomyositis Causes, Symptoms, Treatment, Prevention
    https://www.medicinenet.com/polymyositis/article.htm
    Muscle Pain Polymyositis is a disease of muscle featuring inflammation of the muscle fibers. The cause of the disease is not known. It begins when white blood cells, the immune cells of inflammation, spontaneously invade muscles. […] To date, no cause of polymyositis has been isolated by scientific researchers. There are indicators of heredity (genetic) susceptibility that can be found in some patients. There is indirect evidence of infection by a virus that has yet to be identified in a muscle disease related to polymyositis that is particularly resistant to treatment, called inclusion body myositis. […] Researchers have found that T-cells of the immune system in some polymyositis or dermatomyositis patients reacted against cytomegalovirus (CMV) and that detectable antibodies against CMV were present. Their conclusion was that there may be subsets of patients who develop their disease, in part, because of infection with this particular virus.
  • #31 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    In genetically susceptible individuals, viral, bacterial, and parasitic infections have been suspected to induce autoimmunity and even exacerbate existing autoimmune conditions. […] The relationship of infection to DM onset has been better evaluated in children. […] Parvovirus B19 has been implicated in the pathogenesis of connective tissue diseases such as JDM. […] Coxsackie viruses are enteroviruses of the family Picornaviridae. […] Human polyomavirus (HPyV) 6 and HPyV7 are closely related polyomavirus species and are thought to infect the skin of many healthy individuals in a latent or subclinical manner. […] EBV has been linked to the development of a number of autoimmune disorders. […] HBV and HCV are viruses that can cause liver inflammation and damage. […] The occurrence of DM has also been reported in the setting of HIV infection. […] A case-control study found increased frequency of streptococcal infection in those with JDM than in matched controls.
  • #32 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    The cause of dermatomyositis is unknown. However, genetic, immunologic, infectious, and environmental factors have been implicated. […] A genetic component may predispose to dermatomyositis. Dermatomyositis rarely occurs in multiple family members, but a link to certain human leukocyte antigen (HLA) types (eg, DR3, DR5, DR7) may exist. […] Polymorphisms of tumor necrosis factor (TNF) may be involved; specifically, the presence of the -308A allele is linked to photosensitivity in adults and calcinosis in children. […] Immunologic abnormalities are common in patients with dermatomyositis. Patients frequently have circulating autoantibodies. […] Infectious agents have been suggested as possible triggers of dermatomyositis. These include the following: viruses (eg, coxsackievirus, parvovirus, echovirus, human T-cell lymphotropic virus type 1 [HTLV-1], HIV), Toxoplasma species, Borrelia species.
  • #33 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    New cases of dermatomyositis have been reported following COVID-19 infection or vaccination. […] Cases of drug-induced dermatomyositis have been reported. Dermatomyositis-like skin changes have been reported with hydroxyurea in patients with chronic myelogenous leukemia or essential thrombocytosis. […] Dermatomyositis may be initiated or exacerbated by silicone breast implants or collagen injections, but the evidence for this is anecdotal and has not been verified in case-control studies.
  • #34 Juvenile Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/1417215-overview
    The etiology of JDM is incompletely understood. Evidence suggests a complex interplay of the innate and adaptive immune systems with environmental triggers in a genetically susceptible host. […] Seasonal clustering of JDM in the months of April and May suggests the role of environmental triggers in the onset or exacerbation of the disease. Infectious agents include viruses, parasites, and bacterial antigens that may produce a break in self-tolerance. Infectious agents implicated include the following: Coxsackie B virus, Parvovirus B19, Enteroviruses, Streptococcus species. […] New cases of dermatomyositis have been reported following COVID-19 infection or vaccination. […] Several mechanisms for infection-triggered autoimmunity have been proposed, including molecular mimicry, induction of anti-idiotypic antibodies, and modification of self-antigens through microbial proteins.
  • #35 Dermatomyositis – EyeWiki
    https://eyewiki.org/Dermatomyositis
    In addition, DM may present secondary to paraneoplastic syndromes in breast cancer and other malignancies. […] Risk factors, apart from genetic and environmental etiological factors mentioned above, are not well characterized. […] A case-control study found an association between inhaled pollutants and tobacco smoking during fetal development and juvenile DM. […] An association with high airborne pollution has been proposed in amyopathic DM. […] A higher prevalence of DM was noted in Southern Europe compared to Northern Europe and may be due to the increased exposure to UV-B light, other environmental factors, or differences in genetic background. […] DM is believed to be mediated by C3 cleavage to form C3b and C4b, which activates complement, which is deposited in muscle capillaries and the endothelium of arterioles. […] DM is an idiopathic, microangiopathic myopathy characterized by muscle weakness, Gottron papules and heliotrope rashes, and has a multi-factorial pathogenesis with multiple genetic, immunologic, and environmental factors that contribute.
  • #36 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Cutaneous features of DM including persistent erythema, increased prevalence in sun-exposed areas, and photoaggravation all suggest that UV radiation plays a strong role in disease pathogenesis. […] The prevalence of DM increases significantly with decreasing geographical latitude from northern Europe to southern Europe, suggesting that UV exposure may be implicated in DM pathogenesis. […] Occupational exposure has been linked to the onset of both adult DM and JDM. […] It is well established that increased particulate matter in the air, such as from vehicle and industrial emissions, is associated with increased mortality. […] Various factors during pregnancy such as exposure to fetal antigens, changes in maternal hormonal status, and the reactivation of certain viruses by pregnancy have been considered as triggers for the development of DM.
  • #37 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Cutaneous features of DM including persistent erythema, increased prevalence in sun-exposed areas, and photoaggravation all suggest that UV radiation plays a strong role in disease pathogenesis. […] The prevalence of DM increases significantly with decreasing geographical latitude from northern Europe to southern Europe, suggesting that UV exposure may be implicated in DM pathogenesis. […] Occupational exposure has been linked to the onset of both adult DM and JDM. […] It is well established that increased particulate matter in the air, such as from vehicle and industrial emissions, is associated with increased mortality. […] Various factors during pregnancy such as exposure to fetal antigens, changes in maternal hormonal status, and the reactivation of certain viruses by pregnancy have been considered as triggers for the development of DM.
  • #38 Juvenile Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/1417215-overview
    Type I interferon-alpha/beta genes are overexpressed in dermatomyositis. […] Noninfectious agents implicated in the onset of JDM include D-penicillamine, vaccinations, and bone marrow transplants. […] Patients with human leukocyte antigen DQA1*0501 (HLA-DQA1*0501) have an increased susceptibility to JDM, in a strong linkage disequilibrium to HLA-DR3, compared with age-matched controls in white, black, and Hispanic children. […] Cytokine polymorphisms (eg, the substitution of A to G in the promoter region of tumor necrosis factor [TNF]alpha-308 allele) is associated with a prolonged, refractory course. […] A study that investigated the association between ultraviolet radiation (UVR) exposure and the clinical and autoantibody expression of juvenile idiopathic inflammatory myopathies (IIM) found that short-term UVR exposure prior to illness onset may have a role in the clinical and serologic expression of juvenile myositis. Further research examining the mechanisms of action of UVR in the pathogenesis of juvenile IIM is needed.
  • #39 Dermatomyositis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK558917/
    Dermatomyositis is a rare acquired immune-mediated muscle disease characterized by muscle weakness and skin rash. Although the cause of dermatomyositis is unknown, several genetic, immunologic, and environmental factors are implicated in this condition. […] Multiple studies have indicated that patients with particular human leukocyte antigen (HLA) types are at higher risk of dermatomyositis. […] Although autoantibodies are detected in patients with dermatomyositis, it is unclear whether they play a role in pathogenesis. […] Viruses such as Coxsackie B virus, enterovirus, and parvovirus have been suspected of acting as triggers of dermatomyositis. […] Several drugs can trigger dermatomyositis. […] Dermatomyositis has been observed to occur more frequently among women exposed to high-intensity ultraviolet radiation.
  • #40 Dermatomyositis – EyeWiki
    https://eyewiki.org/Dermatomyositis
    Dermatomyositis is thought to be an autoimmune and/or paraneoplastic condition with genetic and environmental factors contributing to the onset of the disease. […] Multiple genetic, immunologic, and environmental factors have been found to be associated with DM. […] Viruses such as Coxsackie B, enteroviruses, and parvoviruses may be potential triggers for autoimmunity. […] Antineoplastic medications (e.g., hydroxyurea), antibiotics (e.g., penicillin), nonsteroidal anti-inflammatory drugs (e.g., phenylbutazone and D-penicillamine), statins, and some vaccines have also been investigated as potential triggers of DM. […] In addition, high intensity ultraviolet (UV) radiation has been found to occur more frequently among women with DM and may be an environmental factor contributing to the etiology.
  • #41 What Is Dermatomyositis? Causes, Symptoms, Treatments
    https://creakyjoints.org/education/what-is-dermatomyositis/
    No one knows for sure what causes DM. Researchers think that people with DM may have a genetic predisposition for autoimmune disorders. In families, one member can go on to develop, say, multiple sclerosis while another could develop DM. […] Geography may play a role too. For about 20 percent of people with DM, the sun will exacerbate symptoms, so people with DM need to be especially careful when they’re out and about. […] In countries or the regions where there’s more ultraviolet radiation and high sun exposure, there are higher incidents of dermatomyositis, says Dr. Aggarwal. But this is a loose association, he cautions. And you need to have the genetic predisposition in the first place.
  • #42 Dermatomyositis: Symptoms, Causes & Treatments
    https://my.clevelandclinic.org/health/diseases/15701-dermatomyositis
    Dermatomyositis is a rare disease that causes muscle weakness and rashes on your skin. […] Experts arent certain what causes dermatomyositis, but a few causes might include: […] Some studies indicate dermatomyositis is a genetic disorder. […] Dermatomyositis is similar to many autoimmune diseases that make your body’s immune system attack healthy tissue. […] Theres some evidence that suggests a viral infection can trigger dermatomyositis in some people, even after the infection itself is cured. […] Studies have found that living in areas with higher pollution or lower air quality might make you more likely to develop dermatomyositis. […] Dermatomyositis has also been found to increase your risk of developing certain types of cancer. […] Around 15% of people with dermatomyositis develop cancer later in their life.
  • #43 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Cutaneous features of DM including persistent erythema, increased prevalence in sun-exposed areas, and photoaggravation all suggest that UV radiation plays a strong role in disease pathogenesis. […] The prevalence of DM increases significantly with decreasing geographical latitude from northern Europe to southern Europe, suggesting that UV exposure may be implicated in DM pathogenesis. […] Occupational exposure has been linked to the onset of both adult DM and JDM. […] It is well established that increased particulate matter in the air, such as from vehicle and industrial emissions, is associated with increased mortality. […] Various factors during pregnancy such as exposure to fetal antigens, changes in maternal hormonal status, and the reactivation of certain viruses by pregnancy have been considered as triggers for the development of DM.
  • #44 Dermatomyositis – EyeWiki
    https://eyewiki.org/Dermatomyositis
    In addition, DM may present secondary to paraneoplastic syndromes in breast cancer and other malignancies. […] Risk factors, apart from genetic and environmental etiological factors mentioned above, are not well characterized. […] A case-control study found an association between inhaled pollutants and tobacco smoking during fetal development and juvenile DM. […] An association with high airborne pollution has been proposed in amyopathic DM. […] A higher prevalence of DM was noted in Southern Europe compared to Northern Europe and may be due to the increased exposure to UV-B light, other environmental factors, or differences in genetic background. […] DM is believed to be mediated by C3 cleavage to form C3b and C4b, which activates complement, which is deposited in muscle capillaries and the endothelium of arterioles. […] DM is an idiopathic, microangiopathic myopathy characterized by muscle weakness, Gottron papules and heliotrope rashes, and has a multi-factorial pathogenesis with multiple genetic, immunologic, and environmental factors that contribute.
  • #45 Dermatomyositis – EyeWiki
    https://eyewiki.org/Dermatomyositis
    In addition, DM may present secondary to paraneoplastic syndromes in breast cancer and other malignancies. […] Risk factors, apart from genetic and environmental etiological factors mentioned above, are not well characterized. […] A case-control study found an association between inhaled pollutants and tobacco smoking during fetal development and juvenile DM. […] An association with high airborne pollution has been proposed in amyopathic DM. […] A higher prevalence of DM was noted in Southern Europe compared to Northern Europe and may be due to the increased exposure to UV-B light, other environmental factors, or differences in genetic background. […] DM is believed to be mediated by C3 cleavage to form C3b and C4b, which activates complement, which is deposited in muscle capillaries and the endothelium of arterioles. […] DM is an idiopathic, microangiopathic myopathy characterized by muscle weakness, Gottron papules and heliotrope rashes, and has a multi-factorial pathogenesis with multiple genetic, immunologic, and environmental factors that contribute.
  • #46 Dermatomyositis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK558917/
    Dermatomyositis is a rare acquired immune-mediated muscle disease characterized by muscle weakness and skin rash. Although the cause of dermatomyositis is unknown, several genetic, immunologic, and environmental factors are implicated in this condition. […] Multiple studies have indicated that patients with particular human leukocyte antigen (HLA) types are at higher risk of dermatomyositis. […] Although autoantibodies are detected in patients with dermatomyositis, it is unclear whether they play a role in pathogenesis. […] Viruses such as Coxsackie B virus, enterovirus, and parvovirus have been suspected of acting as triggers of dermatomyositis. […] Several drugs can trigger dermatomyositis. […] Dermatomyositis has been observed to occur more frequently among women exposed to high-intensity ultraviolet radiation.
  • #47 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Dermatomyositis (DM) is an autoimmune disease that affects the skin, lungs, and muscle. Although the pathogenesis of DM is not completely understood, several environmental triggers have been linked to DM onset or flare. […] While the exact etiology and pathogenesis of DM are yet to be determined, there is general agreement that DM results from an autoimmune attack on affected organs and can be triggered by environmental factors, such as drugs, infections, ultraviolet (UV) exposure, and pollutant exposure in genetically susceptible individuals. […] Overall, there is general agreement that an autoimmune attack of the skin, muscle, and lungs in DM can be triggered by various environmental factors and warrants further investigation. […] Various herbal supplements, including Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea and Alfalfa stimulate the immune system, and their use has been associated with autoimmune skin disease exacerbations and even disease onset. […] Two case reports and one case series suggest that herbal supplements may cause DM onset or flare in susceptible patients. […] Several drugs have been linked to DM onset or flare, including hydroxyurea, TNF- inhibitors, ICI, and penicillamine. […] In a review of 70 cases by Seidler and Gottlieb, hydroxyurea was the most common cause of drug-induced DM, accounting for 51% of cases. […] TNF- inhibitors, such as infliximab, adalimumab, and etanercept are frequently used for a wide range of autoimmune and rheumatological disorders, such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, and Crohns disease. […] ICI aim to enhance the immune systems ability to recognize and destroy malignant cells. However, autoimmune-related adverse events, including autoimmune skin diseases such as DM, are increasingly being associated with ICI due to the enhanced activation of anti-tumor T cells and non-specific blockage of self-tolerance. […] Penicillamine, a copper chelating agent used primarily in the treatment of Wilson disease as well as previously in rheumatoid arthritis, has also been implicated in DM onset or flare.
  • #48 Drug-induced dermatomyositis
    https://dermnetnz.org/topics/drug-induced-dermatomyositis
    Dermatomyositis is an autoimmune connective tissue disorder involving the skin and the skeletal muscles. Rarely, dermatomyositis may be caused by medications. […] The most common cause of drug-induced dermatomyositis is hydroxyurea, associated with 50% of cases reported in the medical literature, and affecting up to 4% of patients taking hydroxyurea. Many other drugs have been reported to trigger drug-induced dermatomyositis. The list includes the following among many others: Penicillamine, Lipid-lowering agents including statins and HMF-CoA reductase inhibitors, Cyclophosphamide, Non-steroidal anti-inflammatory drugs, Anticonvulsants, Bacillus Calmette-Gurin (BCG) administration and other immunisations, Immune checkpoint inhibitors, TNF inhibitors. […] A history of long-term hydroxyurea use or the recent commencement of a new drug should raise the possibility of a drug cause.
  • #49 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Dermatomyositis (DM) is an autoimmune disease that affects the skin, lungs, and muscle. Although the pathogenesis of DM is not completely understood, several environmental triggers have been linked to DM onset or flare. […] While the exact etiology and pathogenesis of DM are yet to be determined, there is general agreement that DM results from an autoimmune attack on affected organs and can be triggered by environmental factors, such as drugs, infections, ultraviolet (UV) exposure, and pollutant exposure in genetically susceptible individuals. […] Overall, there is general agreement that an autoimmune attack of the skin, muscle, and lungs in DM can be triggered by various environmental factors and warrants further investigation. […] Various herbal supplements, including Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea and Alfalfa stimulate the immune system, and their use has been associated with autoimmune skin disease exacerbations and even disease onset. […] Two case reports and one case series suggest that herbal supplements may cause DM onset or flare in susceptible patients. […] Several drugs have been linked to DM onset or flare, including hydroxyurea, TNF- inhibitors, ICI, and penicillamine. […] In a review of 70 cases by Seidler and Gottlieb, hydroxyurea was the most common cause of drug-induced DM, accounting for 51% of cases. […] TNF- inhibitors, such as infliximab, adalimumab, and etanercept are frequently used for a wide range of autoimmune and rheumatological disorders, such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, and Crohns disease. […] ICI aim to enhance the immune systems ability to recognize and destroy malignant cells. However, autoimmune-related adverse events, including autoimmune skin diseases such as DM, are increasingly being associated with ICI due to the enhanced activation of anti-tumor T cells and non-specific blockage of self-tolerance. […] Penicillamine, a copper chelating agent used primarily in the treatment of Wilson disease as well as previously in rheumatoid arthritis, has also been implicated in DM onset or flare.
  • #50 Drug-induced dermatomyositis
    https://dermnetnz.org/topics/drug-induced-dermatomyositis
    Dermatomyositis is an autoimmune connective tissue disorder involving the skin and the skeletal muscles. Rarely, dermatomyositis may be caused by medications. […] The most common cause of drug-induced dermatomyositis is hydroxyurea, associated with 50% of cases reported in the medical literature, and affecting up to 4% of patients taking hydroxyurea. Many other drugs have been reported to trigger drug-induced dermatomyositis. The list includes the following among many others: Penicillamine, Lipid-lowering agents including statins and HMF-CoA reductase inhibitors, Cyclophosphamide, Non-steroidal anti-inflammatory drugs, Anticonvulsants, Bacillus Calmette-Gurin (BCG) administration and other immunisations, Immune checkpoint inhibitors, TNF inhibitors. […] A history of long-term hydroxyurea use or the recent commencement of a new drug should raise the possibility of a drug cause.
  • #51 What Are the First Signs of Dermatomyositis? Causes
    https://www.emedicinehealth.com/what_are_the_first_signs_of_dermatomyositis/article_em.htm
    What Causes Dermatomyositis? The cause of dermatomyositis is unknown but it resembles some autoimmune disorders. It is thought genetic, immunologic, infectious, and environmental factors may play a role. […] Some cases of drug-induced dermatomyositis have been reported. Medications thought to trigger the illness include: Hydroxyurea, HMG-CoA reductase inhibitors (statins), Penicillamine, Antitumor necrosis factor (TNF) drugs, Antiprogrammed cell death drugs, Interferon, Cyclophosphamide, Quinidine, Bacillus Calmette-Gurin (BCG) vaccine.
  • #52 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Dermatomyositis (DM) is an autoimmune disease that affects the skin, lungs, and muscle. Although the pathogenesis of DM is not completely understood, several environmental triggers have been linked to DM onset or flare. […] While the exact etiology and pathogenesis of DM are yet to be determined, there is general agreement that DM results from an autoimmune attack on affected organs and can be triggered by environmental factors, such as drugs, infections, ultraviolet (UV) exposure, and pollutant exposure in genetically susceptible individuals. […] Overall, there is general agreement that an autoimmune attack of the skin, muscle, and lungs in DM can be triggered by various environmental factors and warrants further investigation. […] Various herbal supplements, including Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea and Alfalfa stimulate the immune system, and their use has been associated with autoimmune skin disease exacerbations and even disease onset. […] Two case reports and one case series suggest that herbal supplements may cause DM onset or flare in susceptible patients. […] Several drugs have been linked to DM onset or flare, including hydroxyurea, TNF- inhibitors, ICI, and penicillamine. […] In a review of 70 cases by Seidler and Gottlieb, hydroxyurea was the most common cause of drug-induced DM, accounting for 51% of cases. […] TNF- inhibitors, such as infliximab, adalimumab, and etanercept are frequently used for a wide range of autoimmune and rheumatological disorders, such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, and Crohns disease. […] ICI aim to enhance the immune systems ability to recognize and destroy malignant cells. However, autoimmune-related adverse events, including autoimmune skin diseases such as DM, are increasingly being associated with ICI due to the enhanced activation of anti-tumor T cells and non-specific blockage of self-tolerance. […] Penicillamine, a copper chelating agent used primarily in the treatment of Wilson disease as well as previously in rheumatoid arthritis, has also been implicated in DM onset or flare.
  • #53 Drug-induced dermatomyositis
    https://dermnetnz.org/topics/drug-induced-dermatomyositis
    Dermatomyositis is an autoimmune connective tissue disorder involving the skin and the skeletal muscles. Rarely, dermatomyositis may be caused by medications. […] The most common cause of drug-induced dermatomyositis is hydroxyurea, associated with 50% of cases reported in the medical literature, and affecting up to 4% of patients taking hydroxyurea. Many other drugs have been reported to trigger drug-induced dermatomyositis. The list includes the following among many others: Penicillamine, Lipid-lowering agents including statins and HMF-CoA reductase inhibitors, Cyclophosphamide, Non-steroidal anti-inflammatory drugs, Anticonvulsants, Bacillus Calmette-Gurin (BCG) administration and other immunisations, Immune checkpoint inhibitors, TNF inhibitors. […] A history of long-term hydroxyurea use or the recent commencement of a new drug should raise the possibility of a drug cause.
  • #54 What Are the First Signs of Dermatomyositis? Causes
    https://www.emedicinehealth.com/what_are_the_first_signs_of_dermatomyositis/article_em.htm
    What Causes Dermatomyositis? The cause of dermatomyositis is unknown but it resembles some autoimmune disorders. It is thought genetic, immunologic, infectious, and environmental factors may play a role. […] Some cases of drug-induced dermatomyositis have been reported. Medications thought to trigger the illness include: Hydroxyurea, HMG-CoA reductase inhibitors (statins), Penicillamine, Antitumor necrosis factor (TNF) drugs, Antiprogrammed cell death drugs, Interferon, Cyclophosphamide, Quinidine, Bacillus Calmette-Gurin (BCG) vaccine.
  • #55 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Dermatomyositis (DM) is an autoimmune disease that affects the skin, lungs, and muscle. Although the pathogenesis of DM is not completely understood, several environmental triggers have been linked to DM onset or flare. […] While the exact etiology and pathogenesis of DM are yet to be determined, there is general agreement that DM results from an autoimmune attack on affected organs and can be triggered by environmental factors, such as drugs, infections, ultraviolet (UV) exposure, and pollutant exposure in genetically susceptible individuals. […] Overall, there is general agreement that an autoimmune attack of the skin, muscle, and lungs in DM can be triggered by various environmental factors and warrants further investigation. […] Various herbal supplements, including Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea and Alfalfa stimulate the immune system, and their use has been associated with autoimmune skin disease exacerbations and even disease onset. […] Two case reports and one case series suggest that herbal supplements may cause DM onset or flare in susceptible patients. […] Several drugs have been linked to DM onset or flare, including hydroxyurea, TNF- inhibitors, ICI, and penicillamine. […] In a review of 70 cases by Seidler and Gottlieb, hydroxyurea was the most common cause of drug-induced DM, accounting for 51% of cases. […] TNF- inhibitors, such as infliximab, adalimumab, and etanercept are frequently used for a wide range of autoimmune and rheumatological disorders, such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, and Crohns disease. […] ICI aim to enhance the immune systems ability to recognize and destroy malignant cells. However, autoimmune-related adverse events, including autoimmune skin diseases such as DM, are increasingly being associated with ICI due to the enhanced activation of anti-tumor T cells and non-specific blockage of self-tolerance. […] Penicillamine, a copper chelating agent used primarily in the treatment of Wilson disease as well as previously in rheumatoid arthritis, has also been implicated in DM onset or flare.
  • #56 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Dermatomyositis (DM) is an autoimmune disease that affects the skin, lungs, and muscle. Although the pathogenesis of DM is not completely understood, several environmental triggers have been linked to DM onset or flare. […] While the exact etiology and pathogenesis of DM are yet to be determined, there is general agreement that DM results from an autoimmune attack on affected organs and can be triggered by environmental factors, such as drugs, infections, ultraviolet (UV) exposure, and pollutant exposure in genetically susceptible individuals. […] Overall, there is general agreement that an autoimmune attack of the skin, muscle, and lungs in DM can be triggered by various environmental factors and warrants further investigation. […] Various herbal supplements, including Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea and Alfalfa stimulate the immune system, and their use has been associated with autoimmune skin disease exacerbations and even disease onset. […] Two case reports and one case series suggest that herbal supplements may cause DM onset or flare in susceptible patients. […] Several drugs have been linked to DM onset or flare, including hydroxyurea, TNF- inhibitors, ICI, and penicillamine. […] In a review of 70 cases by Seidler and Gottlieb, hydroxyurea was the most common cause of drug-induced DM, accounting for 51% of cases. […] TNF- inhibitors, such as infliximab, adalimumab, and etanercept are frequently used for a wide range of autoimmune and rheumatological disorders, such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, and Crohns disease. […] ICI aim to enhance the immune systems ability to recognize and destroy malignant cells. However, autoimmune-related adverse events, including autoimmune skin diseases such as DM, are increasingly being associated with ICI due to the enhanced activation of anti-tumor T cells and non-specific blockage of self-tolerance. […] Penicillamine, a copper chelating agent used primarily in the treatment of Wilson disease as well as previously in rheumatoid arthritis, has also been implicated in DM onset or flare.
  • #57 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    New cases of dermatomyositis have been reported following COVID-19 infection or vaccination. […] Cases of drug-induced dermatomyositis have been reported. Dermatomyositis-like skin changes have been reported with hydroxyurea in patients with chronic myelogenous leukemia or essential thrombocytosis. […] Dermatomyositis may be initiated or exacerbated by silicone breast implants or collagen injections, but the evidence for this is anecdotal and has not been verified in case-control studies.
  • #58 Dermatomyositis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/332783-overview
    New cases of dermatomyositis have been reported following COVID-19 infection or vaccination. […] Cases of drug-induced dermatomyositis have been reported. Dermatomyositis-like skin changes have been reported with hydroxyurea in patients with chronic myelogenous leukemia or essential thrombocytosis. […] Dermatomyositis may be initiated or exacerbated by silicone breast implants or collagen injections, but the evidence for this is anecdotal and has not been verified in case-control studies.
  • #59 Dermatomyositis – Wikipedia
    https://en.wikipedia.org/wiki/Dermatomyositis
    Dermatomyositis may develop as a paraneoplastic syndrome associated with several forms of malignancy. […] It is known to be associated with several viruses, especially coxsackievirus, but no definitive causal link has been found. […] The pathogenesis of dermatomyositis involves an autoimmune-mediated process characterized by immune complex deposition and complement activation, leading to microangiopathy in both muscle and skin tissues. […] As many as 40% of cases of dermatomyositis are paraneoplastic manifestations of an underlying cancer. […] The most commonly associated cancers are ovarian cancer, breast cancer, and lung cancer overall, but the most frequent associations can vary depending on patient race or ethnicity. […] Inherited genetic factors play at least a partial role in developing the disease, and HLA subtypes HLA-DR3, HLA-DR52, and HLA-DR6 seem to create a disposition to autoimmune dermatomyositis.
  • #60 Dermatomyositis: Causes, Symptoms, and Treatment
    https://www.healthline.com/health/dermatomyositis
    The exact cause of dermatomyositis isnt known. However, it has many similarities to an autoimmune disease. […] Having a compromised immune system may also contribute to getting the disease. […] For example, having a viral infection or cancer may compromise your immune system and lead to the development of dermatomyositis. […] About 15 to 30 percent of dermatomyositis cases are associated with malignancy such as breast, ovary, or lung cancer. This is known as paraneoplastic dermatomyositis, meaning the disease is associated with but not directly related to a tumor.
  • #61 Dermatomyositis | AAFP
    https://www.aafp.org/pubs/afp/issues/2001/1101/p1565.html
    Dermatomyositis is an idiopathic inflammatory myopathy with characteristic skin manifestations. […] The etiology of dermatomyositis remains unknown; some studies have reported an association with histocompatability antigens, environmental agents (e.g., virus, drugs) and autoimmunity. […] Although an increased risk of malignancy has not been associated with juvenile dermatomyositis, it has been demonstrated in adults with dermatomyositis. One study suggested a 6.5-fold increased risk of malignancy. […] The most commonly reported malignancies are ovarian and gastric cancer, and lymphoma. […] Skin changes are not different in patients with or without malignancy. Therefore, careful investigation for malignancy should be initiated at the time dermatomyositis is diagnosed.
  • #62 Dermatomyositis | AAFP
    https://www.aafp.org/pubs/afp/issues/2001/1101/p1565.html
    Dermatomyositis is an idiopathic inflammatory myopathy with characteristic skin manifestations. […] The etiology of dermatomyositis remains unknown; some studies have reported an association with histocompatability antigens, environmental agents (e.g., virus, drugs) and autoimmunity. […] Although an increased risk of malignancy has not been associated with juvenile dermatomyositis, it has been demonstrated in adults with dermatomyositis. One study suggested a 6.5-fold increased risk of malignancy. […] The most commonly reported malignancies are ovarian and gastric cancer, and lymphoma. […] Skin changes are not different in patients with or without malignancy. Therefore, careful investigation for malignancy should be initiated at the time dermatomyositis is diagnosed.
  • #63 Dermatomyositis – Wikipedia
    https://en.wikipedia.org/wiki/Dermatomyositis
    Dermatomyositis may develop as a paraneoplastic syndrome associated with several forms of malignancy. […] It is known to be associated with several viruses, especially coxsackievirus, but no definitive causal link has been found. […] The pathogenesis of dermatomyositis involves an autoimmune-mediated process characterized by immune complex deposition and complement activation, leading to microangiopathy in both muscle and skin tissues. […] As many as 40% of cases of dermatomyositis are paraneoplastic manifestations of an underlying cancer. […] The most commonly associated cancers are ovarian cancer, breast cancer, and lung cancer overall, but the most frequent associations can vary depending on patient race or ethnicity. […] Inherited genetic factors play at least a partial role in developing the disease, and HLA subtypes HLA-DR3, HLA-DR52, and HLA-DR6 seem to create a disposition to autoimmune dermatomyositis.
  • #64 Dermatomyositis – Causes | Symptoms | Diagnosis | Treatment
    https://www.icliniq.com/articles/skin-care/dermatomyositis
    The condition of dermatomyositis occurs for an unknown reason. People who are known to be affected by autoimmune disorders have the possibility of getting this condition. Genetic influence can also be the cause of dermatomyositis. In some patients, the reason for dermatomyositis is the influence of environmental factors. The environmental factors include the following: […] Scientists believe it is caused by a viral infection of the muscles or a disturbance in the immune system. It can also happen to patients with cancer in their abdomen, lungs, or other areas. This disease can affect anyone. It most commonly affects children aged 5 to 15 and adults aged 40 to 60. […] Dermatomyositis has been linked to various malignancies, including breast, ovarian, lung, and hematologic cancers, and as well as nasopharyngeal cancer, among Asian populations.
  • #65 Dermatomyositis | AAFP
    https://www.aafp.org/pubs/afp/issues/2001/1101/p1565.html
    Dermatomyositis is an idiopathic inflammatory myopathy with characteristic skin manifestations. […] The etiology of dermatomyositis remains unknown; some studies have reported an association with histocompatability antigens, environmental agents (e.g., virus, drugs) and autoimmunity. […] Although an increased risk of malignancy has not been associated with juvenile dermatomyositis, it has been demonstrated in adults with dermatomyositis. One study suggested a 6.5-fold increased risk of malignancy. […] The most commonly reported malignancies are ovarian and gastric cancer, and lymphoma. […] Skin changes are not different in patients with or without malignancy. Therefore, careful investigation for malignancy should be initiated at the time dermatomyositis is diagnosed.
  • #66 Myositis – Polymyositis and Dermatomyositis – Patient.info
    https://patient.info/doctor/myositis-polymyositis-and-dermatomyositis
    Polymyositis and dermatomyositis have an autoimmune basis. […] Viral infection has been implicated in the form of the human retroviruses HIV and human T-cell lymphotropic virus type I (HTLV-I), the simian retroviruses, and Coxsackievirus B. […] Polymyositis and dermatomyositis may be associated with other autoimmune diseases such as myasthenia gravis, Hashimoto’s thyroiditis, systemic sclerosis and Waldenstrm’s macroglobulinaemia. […] Myositis is associated with an increased risk of malignancy, particularly within three years of initial diagnosis. Dermatomyositis appears to have the strongest association with malignancy. Adenocarcinoma has been reported as the most common type of associated malignancy. Certain cancers – eg, ovarian, lung, breast and pancreatic cancer – are particularly increased with dermatomyositis, and lymphatic and haematopoietic malignancies, such as non-Hodgkin’s disease, in people with polymyositis.
  • #67 Dermatomyositis – Causes | Symptoms | Diagnosis | Treatment
    https://www.icliniq.com/articles/skin-care/dermatomyositis
    The condition of dermatomyositis occurs for an unknown reason. People who are known to be affected by autoimmune disorders have the possibility of getting this condition. Genetic influence can also be the cause of dermatomyositis. In some patients, the reason for dermatomyositis is the influence of environmental factors. The environmental factors include the following: […] Scientists believe it is caused by a viral infection of the muscles or a disturbance in the immune system. It can also happen to patients with cancer in their abdomen, lungs, or other areas. This disease can affect anyone. It most commonly affects children aged 5 to 15 and adults aged 40 to 60. […] Dermatomyositis has been linked to various malignancies, including breast, ovarian, lung, and hematologic cancers, and as well as nasopharyngeal cancer, among Asian populations.
  • #68 Dermatomyositis | AAFP
    https://www.aafp.org/pubs/afp/issues/2001/1101/p1565.html
    Dermatomyositis is an idiopathic inflammatory myopathy with characteristic skin manifestations. […] The etiology of dermatomyositis remains unknown; some studies have reported an association with histocompatability antigens, environmental agents (e.g., virus, drugs) and autoimmunity. […] Although an increased risk of malignancy has not been associated with juvenile dermatomyositis, it has been demonstrated in adults with dermatomyositis. One study suggested a 6.5-fold increased risk of malignancy. […] The most commonly reported malignancies are ovarian and gastric cancer, and lymphoma. […] Skin changes are not different in patients with or without malignancy. Therefore, careful investigation for malignancy should be initiated at the time dermatomyositis is diagnosed.
  • #69 Dermatomyositis Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/diseases-conditions/dermatomyositis
    The cause of dermatomyositis is unknown. Experts think it may be due to a viral infection of the muscles or a problem with the body’s immune system. It may also occur in people who have cancer in the abdomen, lung, or other parts of the body. […] The major causes of death with this condition are cancer and lung disease.
  • #70 Dermatomyositis – Autoimmune Association
    https://autoimmune.org/disease-information/dermatomyositis/
    Dermatomyositis is an autoimmune muscle disease that involves inflammation and a skin rash. The cause of dermatomyositis is unknown. Experts think it may be due to a viral infection of the muscles or a problem with the body’s immune system. It may also occur in patients who have cancer in the abdomen, lung, or other parts of the body. […] The major causes of death with this condition are cancer and lung disease.
  • #71 Adult-onset dermatomyositis
    https://dermnetnz.org/topics/adult-onset-dermatomyositis
    Dermatomyositis is thought to be caused by a microangiopathy affecting skin and muscle. There is a genetic predisposition to the development of dermatomyositis such as the PTPN22 gene and HLA associations identified include: […] Triggers and reported associations have included: […] Most patients have disease-associated autoantibodies, suggesting dermatomyositis is an autoimmune condition. […] Adult-onset dermatomyositis is strongly associated with malignancy; up to 25% of affected adults have an unknown underlying malignancy on diagnosis. The majority are adenocarcinomas.
  • #72 Dermatomyositis | AAFP
    https://www.aafp.org/pubs/afp/issues/2001/1101/p1565.html
    Dermatomyositis is an idiopathic inflammatory myopathy with characteristic skin manifestations. […] The etiology of dermatomyositis remains unknown; some studies have reported an association with histocompatability antigens, environmental agents (e.g., virus, drugs) and autoimmunity. […] Although an increased risk of malignancy has not been associated with juvenile dermatomyositis, it has been demonstrated in adults with dermatomyositis. One study suggested a 6.5-fold increased risk of malignancy. […] The most commonly reported malignancies are ovarian and gastric cancer, and lymphoma. […] Skin changes are not different in patients with or without malignancy. Therefore, careful investigation for malignancy should be initiated at the time dermatomyositis is diagnosed.
  • #73 Myositis – Polymyositis and Dermatomyositis – Patient.info
    https://patient.info/doctor/myositis-polymyositis-and-dermatomyositis
    Polymyositis and dermatomyositis have an autoimmune basis. […] Viral infection has been implicated in the form of the human retroviruses HIV and human T-cell lymphotropic virus type I (HTLV-I), the simian retroviruses, and Coxsackievirus B. […] Polymyositis and dermatomyositis may be associated with other autoimmune diseases such as myasthenia gravis, Hashimoto’s thyroiditis, systemic sclerosis and Waldenstrm’s macroglobulinaemia. […] Myositis is associated with an increased risk of malignancy, particularly within three years of initial diagnosis. Dermatomyositis appears to have the strongest association with malignancy. Adenocarcinoma has been reported as the most common type of associated malignancy. Certain cancers – eg, ovarian, lung, breast and pancreatic cancer – are particularly increased with dermatomyositis, and lymphatic and haematopoietic malignancies, such as non-Hodgkin’s disease, in people with polymyositis.
  • #74 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Cutaneous features of DM including persistent erythema, increased prevalence in sun-exposed areas, and photoaggravation all suggest that UV radiation plays a strong role in disease pathogenesis. […] The prevalence of DM increases significantly with decreasing geographical latitude from northern Europe to southern Europe, suggesting that UV exposure may be implicated in DM pathogenesis. […] Occupational exposure has been linked to the onset of both adult DM and JDM. […] It is well established that increased particulate matter in the air, such as from vehicle and industrial emissions, is associated with increased mortality. […] Various factors during pregnancy such as exposure to fetal antigens, changes in maternal hormonal status, and the reactivation of certain viruses by pregnancy have been considered as triggers for the development of DM.
  • #75 Environmental triggers of dermatomyositis: a narrative review
    https://atm.amegroups.org/article/view/49740/html
    Dermatomyositis (DM) is an autoimmune disease that affects the skin, lungs, and muscle. Although the pathogenesis of DM is not completely understood, several environmental triggers have been linked to DM onset or flare. […] While the exact etiology and pathogenesis of DM are yet to be determined, there is general agreement that DM results from an autoimmune attack on affected organs and can be triggered by environmental factors, such as drugs, infections, ultraviolet (UV) exposure, and pollutant exposure in genetically susceptible individuals. […] Overall, there is general agreement that an autoimmune attack of the skin, muscle, and lungs in DM can be triggered by various environmental factors and warrants further investigation. […] Various herbal supplements, including Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea and Alfalfa stimulate the immune system, and their use has been associated with autoimmune skin disease exacerbations and even disease onset. […] Two case reports and one case series suggest that herbal supplements may cause DM onset or flare in susceptible patients. […] Several drugs have been linked to DM onset or flare, including hydroxyurea, TNF- inhibitors, ICI, and penicillamine. […] In a review of 70 cases by Seidler and Gottlieb, hydroxyurea was the most common cause of drug-induced DM, accounting for 51% of cases. […] TNF- inhibitors, such as infliximab, adalimumab, and etanercept are frequently used for a wide range of autoimmune and rheumatological disorders, such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, and Crohns disease. […] ICI aim to enhance the immune systems ability to recognize and destroy malignant cells. However, autoimmune-related adverse events, including autoimmune skin diseases such as DM, are increasingly being associated with ICI due to the enhanced activation of anti-tumor T cells and non-specific blockage of self-tolerance. […] Penicillamine, a copper chelating agent used primarily in the treatment of Wilson disease as well as previously in rheumatoid arthritis, has also been implicated in DM onset or flare.

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