Successful Treatment with Tacrolimum for Skin Lesions in Amyopathic Dermatomyositis

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  • TAKEO Naoko
    Department of Anatomy, Biology and Medicine (Dermatology), Oita University, Faculty of Medicine
  • ISHIKAWA Kazushi
    Department of Anatomy, Biology and Medicine (Dermatology), Oita University, Faculty of Medicine
  • FUJIWARA Sakuhei
    Department of Anatomy, Biology and Medicine (Dermatology), Oita University, Faculty of Medicine
  • MATSUSHIMA Itomi
    Department of Anatomy, Biology and Medicine (Division of collagen disease, First Department of Internal Medicine), Oita University, Faculty of Medicine
  • ISHII Koji
    Department of Anatomy, Biology and Medicine (Division of collagen disease, First Department of Internal Medicine), Oita University, Faculty of Medicine

Bibliographic Information

Other Title
  • 皮膚症状に対しタクロリムスが有効であったＡｍｙｏｐａｔｈｉｃ　Ｄｅｒｍａｔｏｍｙｏｓｉｔｉｓの１例
  • 症例 皮膚症状に対しタクロリムスが有効であったAmyopathic Dermatomyositisの1例
  • ショウレイ ヒフ ショウジョウ ニ タイシ タクロリムス ガ ユウコウ デ アッタ Amyopathic Dermatomyositis ノ 1レイ

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Description

A 69-year-old female had appetite loss, dry cough, slight fever and multiple joint pains in June 2005 and subsequently dark red erythema developed on her body in August. She had heliotrope eyelids, Gottron?s sign and interstitial pneumonia. She did not complain of muscular weakness, and skeletal muscle enzymes were not elevated, although a high serum KL-6 level was observed. Her skin lesions disappeared after 40 mg of prednisolone per day was administered. In late August, the interstitial pulmonary disease worsened. At the same time she developed multiple skin ulcers on her tongue, right second finger, right shoulder, and left buttock in addition to pustules on the upper back and lumbar area. Pulmonary symptoms responded to methylprednisolone pulse therapy, and the KL-6 level decreased but the skin ulcers on her buttock and shoulder were resistant to this therapy. After high dose intravenous immunoglobulin pulse therapy and tacrolimus with oral prednisolone, ulcers stopped enlarging and surgical closure was performed. In December 2005 when tacrolimus was stopped for 2 months on suspicion of drug-induced liver dysfunction, the KL-6 level became elevated and erythema of her trunk again worsened. After the readministration of tacrolimus, the erythema almost completely resolved and the KL-6 level slowly decreased without any side effects. With this treatment we were able to taper the dose of oral prednisolone and concluded that tacrolimus was effective in our patient.

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 69 (6), 595-600, 2007

    Western Division of Japanese Dermatological Association

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