Cutaneous leukocytoclastic vasculitis in dermatomyositis suggests malignancy.

BACKGROUND

Dermatomyositis (DM) is a rare connective tissue disease which has been shown to be associated with an underlying malignancy.

OBJECTIVE

Evaluation of the prevalence of malignancy in DM at our clinic and search for characteristics of the paraneoplastic form of disease.

METHODS

Retrospective review of patient files and histology reports over the period from 1991 to 1998.

RESULTS

23 patients (14 women and 9 men) with DM could be identified in this time period with a median age at diagnosis of 48 years. Malignancies were found in 5 (22%) cases. The skin biopsies of all patients showed features of DM; in 7 cases, a leukocytoclastic vasculitis was detected. Four of the 5 cases with an associated malignancy demonstrated histologically a vasculitis in lesional skin, compared to only 3 out of 18 cases without malignancy (p < 0.05, Fisher's exact test).

CONCLUSION

Our data suggest that vasculitis in lesional skin biopsies has a predictive value for the presence of underlying malignancy.