Clinical characteristics of patients with antisynthetase syndrome and dermatomyositis-type skin involvement: Insights from the Myo-Spain registry.
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Loarce-Martos Jesús, Tandaipan José Luis, Domínguez-Álvaro Marta, Carrión-Barberà Irene, Nuño-Nuño Laura, Martínez-Barrio Julia, Jovaní Vega, Romero-Bueno Fredeswinda, Ruiz-Lucea Esther, Tomero Eva, Trallero-Araguás Ernesto, Narváez Javier, Camins-Fàbregas Jordi, Ruiz-Román Alberto, de la Cámara-Fernández Isabel, Riveros-Frutos Anne, Flores-Rodríguez V Miguel, Sivera Francisca, Merino-Argumanez Carolina, Juan-Mas Antonio, Altabás-González Irene, Martín-López María, Belzunegui-Otano Joaquín María, Carrasco-Cubero Carmen, Freire-González Mercedes, Rúa-Figueroa Iñigo, Lozano-Rivas Nuria, Suarez-Cuba Julio David, Turrión-Nieves Ana Isabel, Ortega-Castro Rafaela, Alcocer Patricia, Plasencia-Rodríguez Chamaida, Prado-Galbarro Francisco Javier, Cobo-Ibáñez Tatiana
Аннотация
METHODS: We performed a cross-sectional study of baseline data from the Spanish registry of patients with IIM (Myo-Spain). Patients with ASyS (classified as ASyS-DM-skin or ASyS-nonDM-skin) and DM were included. We compared characteristics between groups using univariable analysis. Two multivariable logistic regression models were evaluated: (1) factors associated with DM-type skin lesions among ASyS patients; and (2) factors associated with an ASyS diagnosis among patients with DM-type skin lesions.
RESULTS: We included 194 patients with ASyS (61 [31.4%] ASyS-DM-skin) and 116 with DM. In the multivariable model restricted to patients with ASyS, DM-type skin lesions were positively associated with periungual capillary alterations (OR 2.49, 95% CI 1.10-5.65), and negatively associated with age at diagnosis (OR 0.97, 95% CI 0.94-0.99) and arthralgia (OR 0.39, 95% CI 0.15-1.00). Among patients with DM-type skin lesions, ASyS diagnosis was positively associated with Raynaud's phenomenon (OR 6.84, 95% CI 1.04-44.81), mechanic's hands (OR 12.60, 95% CI 1.55-102.7), and interstitial lung disease (OR 27.83, 95% CI 4.55-170.5), and negatively associated with heliotrope rash or Gottron sign/papules (OR 0.10, 95% CI 0.01-0.73) and muscle weakness at diagnosis (OR 0.11, 95% CI 0.01-0.83). Malignancy was less frequent in ASyS-DM-skin than in DM.
CONCLUSION: ASyS-DM-skin patients displayed a distinct clinical phenotype, characterized by DM-type cutaneous involvement while retaining ASyS features, particularly interstitial lung disease, Raynaud's phenomenon, and mechanic's hands.