皮肤性病诊疗学杂志2026，Vol.33Issue(8)：570-579,10.DOI:10.3969/j.issn.1674-8468.2026.08.002
皮肌炎合并恶性肿瘤的皮肤病理特征分析
Analysis of cutaneous histopathological features of dermatomyositis associated with malig-nancy
摘要
Abstract
Objective To summarize the cutaneous histopathological features of patients with dermatomyositis(DM),identify histopathological clues in patients with concomitant malignancies,and investigate histopathological differences among subtypes of myositis antibodies.Methods A total of 38 patients diagnosed with DM who underwent skin biopsy from January 2017 to October 2025 were retrospectively enrolled.The results of hematoxylin-eosin(HE)staining and direct im-munofluorescence(DIF)were collected.A histopathological evaluation system consisting of 13 bi-nary variables and 5 ordinal variables was established.According to the presence of concomitant malignancy,patients were divided into the cancer-associated myositis(CAM)group(n=6)and the non-cancer-associated myositis(Non-CAM)group(n=32).Based on the myositis antibody profile,patients were further subclassified into transcription intermediary factor 1-γ(TIF1-γ),Mi-2,melanoma differentiation-associated protein 5(MDA5),nuclear matrix protein 2(NXP2),small ubiquitin-like modifier activating enzyme 1(SAE1),myositis-associated antibody(MAA),and seronegative subgroups.The cutaneous histopathological features of each group were summa-rized,and intergroup differences were analyzed.Results HE staining revealed lymphocytic infil-tration at the dermoepidermal junction in all patients(100%).Common histopathologic features included basal cell liquefactive degeneration(86.84%),spongiosis(81.58%),edema of super-ficial dermal collagen fibers(81.58%),and pigment incontinence(78.95%).Among the 32 patients who underwent DIF,12(37.50%)were negative for all tested markers,whereas 12(37.50%)had at least two positive DIF findings.Immunoglobulin M(IgM)deposition along the basement membrane zone(BMZ)was the most frequent finding(50.00%),whereas immuno-globulin A(IgA)deposition was the least frequent(3.13%).Compared with the Non-CAM group,the CAM group had a higher frequency of intracellular edema within the spinous layer(66.67%vs.12.50%,P=0.012),as well as higher dyskeratosis scores(1.5 vs.0.0;P=0.048)and basal cell liquefactive degeneration scores(2.0 vs.1.0;P=0.032).The cutaneous histopathology of all antibody subtypes was dominated by the interface injury shared by DM.Con-clusions The core histopathologic features of DM skin lesions are lymphocytic infiltration at the dermoepidermal junction and basal cell liquefactive degeneration.IgM deposition along the BMZ is the most common DIF finding and may aid in diagnosis.Compared with the Non-CAM group,the CAM group more frequently exhibited intracellular edema and showed more severe dyskeratosis and basal cell liquefactive degeneration,suggesting that these histopathologic changes may be associat-ed with an increased risk of malignancy.关键词
皮肌炎/肌炎抗体/皮肤病理/界面皮炎/恶性肿瘤相关肌炎Key words
dermatomyositis/myositis autoantibodies/cutaneous histopathology/interface dermatitis/cancer-associated myositis引用本文复制引用
廖炜琪,杨泓,唐旭华,陈小红,韩建德,粟慧琳..皮肌炎合并恶性肿瘤的皮肤病理特征分析[J].皮肤性病诊疗学杂志,2026,33(8):570-579,10.基金项目
国家自然科学基金项目(82102417) （82102417）
