Track

Clinical Studies

Abstract

Background: Dermatomyositis (DM) is associated with increased risk of underlying malignancy in patients with autoantibodies to transcriptional intermediary factor 1-γ (TIF1-γ). We aimed to characterize skin biopsies from a single-center cohort of TIF1-γ(+) DM patients and identify histopathologic features associated with malignancy. Methods: We performed a retrospective review of our departmental registry of skin biopsies from patients with DM. We selected only those from TIF1-γ(+) patients. We compared biopsies from patients with an associated malignancy to those without with respect to various histologic features. Results: Our cohort consisted of 108 biopsies from 79 patients with TIF1-γ DM. Of these, 23 biopsies were taken from patients with an associated malignancy. Biopsies from patients with cancer within 3 years of DM were significantly more likely to have dyskeratotic keratinocytes in the granular layer of the epidermis (22% vs. 1%, p=0.0002) and dermal edema (52% vs. 29%, p=0.0301). When controlling for age and sex, presence of dyskeratotic cells in the granular layer was associated with nearly 18 times the odds of cancer within 3 years of DM (OR: 17.87; 95% CI: 1.81, 176.24, p=0.0135). Conclusion: When considered in the context of a patient’s clinical risk factors, presence of dyskeratotic cells in suprabasilar layers of the epidermis may inform clinicians about risk of underlying malignancy in TIF1-γ(+)DM.