Gottron Sign with Ulceration Is Not a Poor Prognostic Factor in Patients with Dermatomyositis and Interstitial Lung Disease

To the Editor: We read the recent article by Cao, et al 1 with great interest. They reported that patients with dermatomyositis (DM) who have Gottron papule/sign with ulceration show an increased risk of interstitial lung disease (ILD) and a significantly lower cumulative survival rate. Unlike Cao, et al , we found that the survival of DM patients with ILD and ulcerated Gottron sign was not worse than that of patients without ulceration. We retrospectively reviewed all the adult patients with DM admitted to our department from 2000 to 2012. The criteria for diagnosis of DM were the same as those used by Cao, et al 1. Clinical features and laboratory test results were assessed from the medical records, with laboratory data being those obtained at the first admission. ILD was diagnosed by detection of interstitial changes on chest computed tomography. Cancer-associated myositis was diagnosed if a malignancy was detected within 3 years … Address correspondence to Dr. T. Nagashima, Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, Tochigi 329-0498, Japan. E-mail: naga4ma{at}jichi.ac.jp