July 2002

When and How Should the Patient With Dermatomyositis or Amyopathic Dermatomyositis Be Assessed for Possible Cancer?

Author Affiliations

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Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

Arch Dermatol. 2002;138(7):969-971. doi:10.1001/archderm.138.7.969

IN 1975 when I first became interested in the relationship between dermatomyositis and cancer, the data were controversial about the existence of a relationship, whether the relationship was unique for those patients with cutaneous disease as opposed to the entire group of patients with inflammatory myopathy, and the exact method that should be recommended for the discovery of malignancy.1,2 In the late 1970s and early 1980s, the recommendations for the evaluation of the patient with dermatomyositis (DM) or polymyositis (PM) varied widely, but in general we were taught that on diagnosis the patient should undergo a "malignancy" workup that began with a complete history and physical examination, "routine" laboratory tests (eg, a complete blood count and serum multiphasic analysis), a sigmoidoscopic examination, and radiographic studies including mammography screening, chest radiography, upper gastrointestinal tract imaging, barium enema, and an intravenous pyelography. Some authors went on to suggest that if no malignancy was discovered with this testing, the evaluation should continue with an exploratory laparotomy.3

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