Cutaneous leukocytoclastic vasculitis in dermatomyositis suggests malignancy

Abstract

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.