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Multicenter Study
. 2023 Jul;21(7):741-748.
doi: 10.1111/ddg.15089. Epub 2023 May 23.

Predictive factors for anti-MDA5 antibody in patients with dermatomyositis: a retrospective multicenter study

María Castellanos-Gonzalez  1 , Beatriz Butrón Bris  2 , Isabel Bielsa Marsol  3 , Mónica Munera Campos  4 , Ricardo Ruiz-Villaverde  4 , Concha Postigo Llorente  5 , Almudena Nuno-Gonzalez  6 , Jesús Tercedor Sánchez  7 , Eva Chavarría Mur  8 , Rosa Giménez García  9 , Ana Bauza Alonso  10 , Gloria Aparicio Español  11 , Yolanda Hidalgo García  12 , Júlia María Sánchez Schmidt  13 , Manuel Almagro Sánchez  14 , Esther Roé Crespo  15 , Elena de Las Heras Alonso  16 , Gonzalo Gallo-Pineda  17 , Jose Antonio Avilés Izquierdo  18 , David Varillas-Delgado  19
Affiliations
Multicenter Study

Predictive factors for anti-MDA5 antibody in patients with dermatomyositis: a retrospective multicenter study

María Castellanos-Gonzalez et al. J Dtsch Dermatol Ges. 2023 Jul.

Abstract

Background and objectives: Melanoma differentiation-associated gene 5 antibody (anti-MDA5) in dermatomyositis (DM) is associated with rapidly progressive interstitial lung disease and poor prognosis. Early diagnosis is key to improving the prognosis of these patients. The aim was to confirm cutaneous characteristics in patients with anti-MDA5 dermatomyositis and to explore new diagnostic markers for the presence of anti-MDA5 (anti-MDA5+ ).

Patients and methods: A multicenter cross-sectional retrospective cohort study of 124 patients diagnosed with DM, of which 37 were anti-MDA5+ . Demographic data, laboratory data, and clinical manifestations were collected.

Results: Anti-MDA5+ DM is characterized by a distinct mucocutaneous phenotype that includes oral lesions, alopecia, mechanic's hands, palmar and dorsal papules, palmar erythema, vasculopathy, and skin ulceration. We found vasculopathy and digit tip involvement very frequently in anti-MDA5+ patients (p <0.001), being a diagnostic marker of anti-MDA5+ (OR, 12.355; 95% CI 2.850-79.263; p = 0.012 and OR, 7.447; 95% CI 2.103-46.718; p = 0.004, respectively). The presence of ulcers deserves special mention, especially in anti-MDA5+ patients, because in our cohort, up to 97% of the anti-MDA5+ patients had ulcers.

Conclusions: In patients with suspected DM with digit tip involvement or vasculopathy, the presence of anti-MDA5 antibodies must be ruled out, as it may be a clinical predictor.

Keywords: Dermatomyositis; anti-MDA5; arthritis; ulcers; vasculopathy.

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References

REFERENCES

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