Keratotic Palmar Papules in a Dermatomyositis Patient Preceding the Development of Interstitial Pneumonia
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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We report on five patients with dermatomyositis (DM) and cutaneous necrosis. Patients presented with classic DM skin eruptions, mild myositis, and a high incidence (4/5) of interstitial pneumonia. Cutaneous necrosis developed independently of steroid therapy, with the majority of lesions being cured following several months of sterilization treatment. In addition, one patient with accompanying cancer presented with multiple necrotic lesions. Topical treatment using gentiana violet against local infection was considered to have been essential in accelerating healing.
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The clinical features of 8 cases with amyopathic dermatomyositis (ADM) wereretrospectively compared with those of 53 cases with typical dermatomyositis ( DM). Incidence of interstitiallung disease, joint pain, fever, concurrent cancer were 4/8, 3/8, 3/8 and 0 in ADM group and those were 40% , 34% , 32% and 11 % in DM group respectively. The prevalence of interstitial lung disease in ADMgroup was significantly higher than that in DM group, which indicates that ADM patient should be properlytreated.
Key words:
Dermatomyositis; Pneumonia, Interstitial
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Clinical analysis of 7 dermatomyositis cases with acute interstitial pneumonia and literature review
Objective To analysis the clinical features of dermatomyositis(DM)complicated with acute interstitial pneumonia(AIP),and to explore the cause of the disease to improve the treatment.Methods Seven cases of dermatomyositis complicated with AIP in our hospital from 1997 to 2005 were studied retro- spectively and the literatures were reviewed.Resets Seven dermatomyositis patients had typical cutaneous vasculitis with slight symptom of myositis.The electromyogram showed myogenic damage.The Jo-I antibodies were all negative.Simultaneously or shortly after the diagnosis of dermatomyositis,all patients presented with high fever,dry cough and progressed dyspnea.The chest X-ray or high-resolution computed tomography dis- played diffuse pulmonary interstitial changes which progressed rapidly.All patients died despites anti-infec- tious treatment and high dose steroid therapy.Conclusion AIP is the pulmonary injury of amyopathic or hy- pomyopathic dermatomyositis.In order to improve the prognosis,early diagnosis should be emphasized and in- terdisciplinary cooperation should be strengthened.
High-resolution computed tomography
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Abstract Aim To investigate the clinical characteristics and related risk factors of dermatomyositis(DM) complicated with interstitial pneumonia(ILD). Methods The clinical data of 105 patients with dermatomyositis were hospitalized in the respiratory department or rheumatic Immunology Department of the First Affiliated Hospital of Harbin Medical University from January 2018 to December 2021 and underwent pulmonary imaging examination were retrospectively analyzed. The hospital medical record room records were used as the data source, including 55 cases in the DM-ILD group and 50 cases in DM without the ILD group as the control group. Results there were significant differences in ESR, C-reactive protein, KL-6, cough, chest tightness/shortness of breath, and Velcro rale between the two groups (P < 0.05); Multivariate logistic regression analysis showed that the increase of KL-6 was an independent risk factor for DM-ILD. Conclusion the increase of KL-6 in patients with dermatomyositis should be vigilant against ILD occurrence.
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Abstract We experienced a case of transient dermatomyositis with interstitial pneumonia, which was diagnosed on the basis of clinical manifestation and histology. The patient's symptoms, including both dermatomyositis and interstitial pneumonia, improved without pharmacological treatment.
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