Dermatomyositis induced by drug therapy: a review of case reports.
BACKGROUND
Drugs have occasionally been implicated in dermatomyositis (DM) onset.


OBJECTIVE
We sought to review case reports of drug-induced DM.


METHODS
Articles were gathered from MEDLINE and bibliographies of acquired reports. Causality was assessed using World Health Organization criteria. Clinical characteristics, management, and resolution were examined.


RESULTS
In 70 reported cases, 50% of patients were female and the median age was 57 years. Hydroxyurea was implicated in 51% of cases. All cases had pathognomonic (76%) or compatible (24%) cutaneous findings. Hydroxyurea cases lacked myositis, but myositis was described in 79.4% of nonhydroxyurea cases. Drug causality was probable (25.7%) or possible (74.3%), but not certain in any case. Most patients had underlying pathology associated with DM (44% had malignancy; 16% had rheumatoid arthritis). Of the sample, 84.3% had improvement of DM after discontinuation of the drug.


CONCLUSIONS
Case reports may emphasize unusual findings.


CONCLUSIONS
Further work is needed to differentiate drug effects from underlying, predisposing factors.
Seidler
Anne M
AM
Department of Dermatology, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts 02111-1533, USA. anne.seidler@alumni.tufts.edu
Gottlieb
Alice B
AB
D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000032:analysis; D001327:Autoimmune Diseases / Q000188:drug therapy; D003520:Cyclophosphamide / Q000009:adverse effects; D003882:Dermatomyositis / Q000139:chemically induced* / Q000473:pathology; D005047:Etoposide / Q000009:adverse effects; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D012867:Skin / Q000473:pathology*
D000974:Antibodies, Antinuclear; D005047:Etoposide; D003520:Cyclophosphamide; D006918:Hydroxyurea