title: Intractable skin necrosis and interstitial pneumonia in amyopathic dermatomyositis, successfully treated with cyclosporin A.
abstract: We report a patient with amyopathic dermatomyositis (DM) who mainly showed interstitial pneumonia and intractable skin necrosis in bilateral elbows and soles with a poor response to immunomediated therapy, including corticosteroid and high-dose intravenous immunoglobulin. Soon after starting oral cyclosporin A (CyA) the skin lesions healed completely and the interstitial pneumonia promptly improved in parallel with a decrease in serum KL-6. Since fatal interstitial pneumonia is frequently associated with amyopathic DM as in this case, administration of CyA should be actively considered as a therapeutic option when clinical symtoms are progressive and resistant to conventional treatments.
authors.affiliation: Third Department of Medicine, Shinshu University School of Medicine, Matsumoto.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimojima
authors.forename: Wataru
authors.initials: W
authors.lastname: Ishii
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hoshi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Matsuda
authors.forename: Takao
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Shu-ichi
authors.initials: S
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use*; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D009336:Necrosis; D012867:Skin / Q000473:pathology*
chemical_list: D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D016572:Cyclosporine