Intractable skin necrosis and interstitial pneumonia in amyopathic dermatomyositis, successfully treated with cyclosporin A

Intern Med. 2003 Dec;42(12):1253-8. doi: 10.2169/internalmedicine.42.1253.

Abstract

We report a patient with amyopathic dermatomyositis (DM) who mainly showed interstitial pneumonia and intractable skin necrosis in bilateral elbows and soles with a poor response to immunomediated therapy, including corticosteroid and high-dose intravenous immunoglobulin. Soon after starting oral cyclosporin A (CyA) the skin lesions healed completely and the interstitial pneumonia promptly improved in parallel with a decrease in serum KL-6. Since fatal interstitial pneumonia is frequently associated with amyopathic DM as in this case, administration of CyA should be actively considered as a therapeutic option when clinical symtoms are progressive and resistant to conventional treatments.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cyclosporine / therapeutic use*
  • Dermatomyositis / complications*
  • Dermatomyositis / drug therapy*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use*
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / etiology*
  • Male
  • Necrosis
  • Skin / pathology*

Substances

  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Cyclosporine