Since it was first reported in 1916, a correlation between inflammatory myopathies and cancer has been noted in several studies. Population studies have confirmed this relationship, and the phrase cancer-associated myopathy has entered the vernacular. Over the past decade, research efforts have shifted toward revealing associations between autoantibodies and clinical phenotypes. One subset of auto-antigens targeting p155/140 have been implicated in oncogenesis and may play a role in screening cancer patients for inflammatory myositis.
Explore this issueFebruary 2019
At our rheumatology clinic, an 81-year-old woman with a past medical history of an undifferentiated neuroendocrine carcinoid tumor involving the ovaries and bowel presented for evaluation of a skin rash concerning for dermatomyositis.
The patient’s malignancy had initially manifested as a bowel obstruction, with metastasis to the mesenteric lymph nodes. Eighteen months prior to the visit, she underwent a bilateral oophorectomy. She subsequently began to develop a pruritic rash over her chest, which eventually covered her back, arms, stomach and legs (see Figures 1, 2 and 3, right and opposite).
The rash initially improved with the application of topical triamcinolone cream. Subsequently, she began to experience myalgias in her shoulders, legs and proximal arms. This pain was accompanied by the appearance of periorbital edema. She was eventually sent to a dermatologist for further evaluation.