Frontiers in immunology · 2026
Malignant erythema as a high-specificity cutaneous indicator of malignancy in adult dermatomyositis: a retrospective cohort study.
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Xing Xiaojing, Li Zihang, Lin Biwen
Аннотация
BACKGROUND: Dermatomyositis (DM) is associated with a substantially elevated risk of malignancy, yet the cutaneous features predictive of cancer risk in adults remain insufficiently defined.
OBJECTIVES: This study aimed to characterize cutaneous manifestations and clinical factors associated with malignancy in adult DM, with a focus on malignant erythema.
METHODS: This retrospective cohort study included 261 adults with DM admitted between 2016 and 2023 and followed up till June 2025. Clinical data, laboratory indicators (including creatine kinase [CK] and lactate dehydrogenase [LDH]), autoantibodies, and skin findings were systematically evaluated. The primary outcome was the occurrence of malignant tumors.
RESULTS: Twenty‑six patients (10%) developed malignancy. Malignant erythema was identified in 35 patients (13.3%), among whom 14 (40%) had malignancy. Both anti-transcription intermediary factor-1 γ (anti-TIF-1 γ) antibodies and malignant erythema were independently associated with malignancy (odds ratio [OR] = 18.231, 95% confidence interval [CI] 4.568-72.756, P < 0.001; OR = 17.588, 95% CI 2.151-143.824, P = 0.007). Malignant erythema demonstrated higher specificity for tumor prediction than anti-TIF-1 γ antibodies (91.1% vs. 86%, P < 0.001), while sensitivity did not differ significantly (53.8% vs. 73.1%, P = 0.190). while.
CONCLUSION: Malignant erythema is a distinctive poikilodermatous manifestation strongly associated with malignancy in adult DM. Its high specificity suggests that malignant erythema may serve as a valuable clinical indicator for malignancy risk and a useful complement to anti-TIF-1 γ antibody testing.
OBJECTIVES: This study aimed to characterize cutaneous manifestations and clinical factors associated with malignancy in adult DM, with a focus on malignant erythema.
METHODS: This retrospective cohort study included 261 adults with DM admitted between 2016 and 2023 and followed up till June 2025. Clinical data, laboratory indicators (including creatine kinase [CK] and lactate dehydrogenase [LDH]), autoantibodies, and skin findings were systematically evaluated. The primary outcome was the occurrence of malignant tumors.
RESULTS: Twenty‑six patients (10%) developed malignancy. Malignant erythema was identified in 35 patients (13.3%), among whom 14 (40%) had malignancy. Both anti-transcription intermediary factor-1 γ (anti-TIF-1 γ) antibodies and malignant erythema were independently associated with malignancy (odds ratio [OR] = 18.231, 95% confidence interval [CI] 4.568-72.756, P < 0.001; OR = 17.588, 95% CI 2.151-143.824, P = 0.007). Malignant erythema demonstrated higher specificity for tumor prediction than anti-TIF-1 γ antibodies (91.1% vs. 86%, P < 0.001), while sensitivity did not differ significantly (53.8% vs. 73.1%, P = 0.190). while.
CONCLUSION: Malignant erythema is a distinctive poikilodermatous manifestation strongly associated with malignancy in adult DM. Its high specificity suggests that malignant erythema may serve as a valuable clinical indicator for malignancy risk and a useful complement to anti-TIF-1 γ antibody testing.