title: Panniculitis associated with dermatomyositis and recurrent ovarian cancer.
abstract: BACKGROUND
  Panniculitis is a rare cutaneous manifestation of dermatomyositis (DM), typically presenting as tender, erythematous subcutaneous nodules. Complications, such as pain, calcinosis, and lipoatrophy, are associated with high morbidity. While it has been suggested that panniculitis in DM may correlate with a better prognosis, our understanding of its true significance, prognostic implications, and management is limited by the paucity of reported cases. We describe the first reported case to our knowledge of DM-associated panniculitis in the setting of ovarian adenocarcinoma as well as in association with a recurrent malignancy.
  
  
  METHODS
  A 63-year-old woman with a history of DM and recurrent ovarian adenocarcinoma presented with multiple painful, erythematous subcutaneous nodules on the bilateral upper arms, thighs, and buttocks. Histologic examination showed lymphoplasmacytic panniculitis with associated dermal mucin deposition, consistent with lobular panniculitis in association with connective-tissue disease. Treatment with oral methotrexate resulted in sustained clinical improvement over a 10-month period.
  
  
  CONCLUSIONS
  Although panniculitis in DM has previously been suggested to be a good prognostic indicator, our case report describes an association with ovarian adenocarcinoma and a recurrent malignancy. Methotrexate may be an effective treatment for panniculitis in DM.
authors.affiliation: Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: Sasha D
authors.initials: SD
authors.lastname: Girouard
authors.forename: Nicole F
authors.initials: NF
authors.lastname: Velez
authors.forename: Richard T
authors.initials: RT
authors.lastname: Penson
authors.forename: Elena M
authors.initials: EM
authors.lastname: Massarotti
authors.forename: Ruth Ann
authors.initials: RA
authors.lastname: Vleugels
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000284:Administration, Oral; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003882:Dermatomyositis / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000150:complications* / Q000473:pathology; D015434:Panniculitis / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D008727:Methotrexate