临床无肌病性皮肌炎诊断标准的演进  

Evolution of diagnostic criteria for clinically amyopathic dermatomyositis

作　　者：曹华[1] 郑捷[1] Cao Hua;Zheng Jie(Department of Dermatology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院皮肤科,上海200025

出　　处：《中华皮肤科杂志》2022年第11期1008-1013,共6页Chinese Journal of Dermatology

基　　金：国家自然科学基金(81573037、81872523、82073432);国家临床重点专科建设项目(2012649);上海市科委医学引导类项目(134119a6100);上海申康医院发展中心临床创新三年行动计划项目(16CR3084B);上海交通大学医学院高峰学科--临床医学研究型医师项目(20172009);上海市医苑新星青年医学人才培养资助计划杰出青年医学人才类项目(2019)。

摘　　要：目前皮肌炎诊断使用最广泛的标准是Bohan和Peter标准,该标准要求患者除典型皮疹外,还须满足至少2条肌炎表现才能诊断皮肌炎。临床无肌病性皮肌炎(CADM)因无肌炎表现而被排除在外,这使CADM的早期研究十分匮乏,不被临床医生所重视。另外,诊断CADM依赖于对皮疹的认识和皮损组织病理表现,因CADM早期皮疹表现不典型,往往被误诊为玫瑰痤疮、脂溢性皮炎、红斑狼疮等其他疾病,从而影响早期诊断和治疗以及对疾病预后的判断。本文梳理CADM的诊断标准,以利于其早期识别和诊断,也为开展相关临床研究提供依据。At present,the Bohan and Peter criteria are the most widely used criteria for the diagnosis of dermatomyositis,which require patients to meet at least 2 criterion items for myositis in addition to typical skin lesions before the diagnosis of dermatomyositis.Clinically amyopathic dermatomyositis(CADM)has been excluded due to the absence of myositis manifestations,resulting in a lack of early studies on this type of dermatomyositis,and little attention has been paid to it by clinicians.In addition,the diagnosis of CADM depends on the understanding of skin lesions and their histopathological manifestations.Because of atypical early skin lesions,CADM is often misdiagnosed as rosacea,seborrheic dermatitis,lupus erythematosus and other diseases,which affects the early diagnosis,treatment and prognosis of patients.This article summarizes the evolution of diagnostic criteria for CADM,in order to promote its early recognition and diagnosis,and also to provide a basis for future clinical research.

关 键 词：皮肌炎 诊断 临床无肌病性皮肌炎 诊断标准 

分 类 号：R593.26[医药卫生—内科学]