Correct!
5. All of the above

ILD occurs in 60% to 80% of patients with DM/PM and is even higher with amyopathic dermatomyositis. NSIP is reported to be the most common histologic pattern, followed by DAD. Lung biopsy is usually not necessary if ILD is present in patient with clinical findings of DM/PM. Corticosteroids are the usual initially recommended treatment for ILD associated with DM/PM.

Amyopathic dermatomyositis is seen in about 20% of patients with dermatomyositis and is characterized by cutaneous findings Gottron papules on the extensor aspects of metacarpal and interphalangeal joints, periungal erythema or facial heliotrope rash with no muscle involvement or only minimal weakness.

Dermatomyositis is associated with a 6-fold higher risk of malignancy than the general population. The risk is highest with the first year after diagnosis and decreases slowly over the subsequent 5 years. Cancer may present prior to the diagnosis, concurrently (as in the patient presented), or after the diagnosis of DM/PM. It is recommended that cancer screening be done, although there is not a consensus on the specific screening procedures.

References 

  1. Waldman R, DeWane ME, Lu J. Dermatomyositis: Diagnosis and treatment. J Am Acad Dermatol. 2020 Feb;82(2):283-296. [CrossRef] [PubMed]
  2. Udkoff J, Cohen PR. Amyopathic Dermatomyositis: A Concise Review of Clinical Manifestations and Associated Malignancies. Am J Clin Dermatol. 2016 Oct;17(5):509-518. [CrossRef] [PubMed]
  3. Long K, Danoff SK. Interstitial Lung Disease in Polymyositis and Dermatomyositis. Clin Chest Med. 2019 Sep;40(3):561-572. [CrossRef] [PubMed]

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