Laboratory Features Elevation of sarcoplasmic enzymes in serum (creatine phosphokinase, aldolase, transaminases and lactic dehydrogenase) is valuable both for diagnosis and for following the clinic...

Polymyositis and dermatomyositis (first of two parts)

Although there appears to be an increased incidence of malignancy among patients with dermatomyositis, demonstration of definitive statistical significance is precluded by the lack of large, controlled series. Patients with the two diseases tend to be older than the general dermatomyositis population and younger than those with cancer alone; and there is a preponderance of female patients. Tumors of the ovary and stomach are more frequently observed than in the general population, while colorectal malignancies are underrepresented. Most reported cases show development of the diseases within a year of one another, and, in some patients, the course of the myopathy follows that of the tumor. No definitive cause for the myopathy in these patients has been established.

Dermatomyositis and malignancy. a review of the literature

Interstitial lung disease associated with the idiopathic inflammatory myopathies: what progress has been made in the past 35 years?

Background Methotrexate remains a valuable option for the treatment of psoriasis. This report will summarize studies regarding the use of methotrexate since the last guidelines were published in 1998. Objective A task force of the National Psoriasis Foundation Medical Board was convened to evaluate treatment options. Our aim was to achieve a consensus on new updated guidelines for the use of methotrexate in the treatment of psoriasis. Methods Reports in the literature were reviewed regarding methotrexate therapy. Results A consensus was achieved on use of methotrexate in psoriasis including specific recommendations on dosing and monitoring. The consensus received unanimous approval from members of the Medical Board of the National Psoriasis Foundation. Limitations There are few evidence-based studies on the treatment of psoriasis with methotrexate. Many of the reviewed reports are for the treatment of rheumatoid arthritis. Conclusions Methotrexate is a safe and effective drug for the treatment of psoriasis. Appropriate patient selection and monitoring will significantly decrease the risks of side effects. In patients without risk factors for hepatic fibrosis, liver biopsies may not be indicated or the frequency of liver biopsies may be markedly reduced.

https://www.jaad.org/article/S0190-9622(08)02482-1/pdf

Methotrexate and psoriasis: 2009 National Psoriasis Foundation Consensus Conference

In all of its components, the immune system shows regularly recurring, rhythmic variations in numerous frequencies; the circadian (about 24 h) rhythms are the best explored. The circadian variations in immunocompetent cells circulating in the peripheral blood are of a magnitude to require attention in medical diagnostics. Both the humoral arm and the delayed (cellular) arm of the immune system function in a rhythmic manner. The response of the immune system to introduction of an antigen and to challenge of the sensitized organism varies in extent in the circadian frequency range and also in lower frequencies, for example, of about a week (circaseptan) or seasonally (circannual). The medical application of the biologic rhythms of the immune system extends to diagnostic measures, as well as treatment.

Biologic Rhythms in the Immune System

Treatment of dermatomyositis with methotrexate

SummaryThe cellular mechanism of immunologic tolerance in cyclophosphamide-treated mice was analyzed. Thymocytes from these animals failed to act synergistically with normal marrow cells in heavily irradiated recipients. By contrast, the marrow cells of tolerant mice cooperated with normal thymocytes in the X-rayed recipients. Tolerance in the drug-treated mice was broken by administration of thymocytes, but not by marrow cells. It was concluded that the target cell in drug-induced immunologic tolerance is a thymus-dependent lymphocyte.

Amira Many

Papers

Treatment of dermatomyositis with methotrexate

Drug-Induced Immunologic Tolerance: Site of Action of Cyclophosphamide

Periodicity during recovery of immune response after cyclophosphamide treatment.