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Peer-reviewedCC BYFrontiers in immunology

Malignant erythema as a high-specificity cutaneous indicator of malignancy in adult dermatomyositis: a retrospective cohort study

  1. 1Department of Dermatology, Capital Medical University Affiliated Beijing Shijitan Hospital , ,
  2. 2Department of Dermatology, First Medical Centre of Chinese People's Liberation Army (PLA) General Hospital , ,

Abstract

Background: Dermatomyositis (DM) is associated with a substantially elevated risk of malignancy, yet the cutaneous features predictive of cancer risk in adults remain insufficiently defined.

Objectives: This study aimed to characterize cutaneous manifestations and clinical factors associated with malignancy in adult DM, with a focus on malignant erythema.

Methods: This retrospective cohort study included 261 adults with DM admitted between 2016 and 2023 and followed up till June 2025. Clinical data, laboratory indicators (including creatine kinase [CK] and lactate dehydrogenase [LDH]), autoantibodies, and skin findings were systematically evaluated. The primary outcome was the occurrence of malignant tumors.

Results: Twenty‑six patients (10%) developed malignancy. Malignant erythema was identified in 35 patients (13.3%), among whom 14 (40%) had malignancy. Both anti-transcription intermediary factor-1 γ (anti-TIF-1 γ) antibodies and malignant erythema were independently associated with malignancy (odds ratio [OR] = 18.231, 95% confidence interval [CI] 4.568–72.756, P < 0.001; OR = 17.588, 95% CI 2.151–143.824, P = 0.007). Malignant erythema demonstrated higher specificity for tumor prediction than anti-TIF-1 γ antibodies (91.1% vs. 86%, P < 0.001), while sensitivity did not differ significantly (53.8% vs. 73.1%, P = 0.190). while.

Conclusion: Malignant erythema is a distinctive poikilodermatous manifestation strongly associated with malignancy in adult DM. Its high specificity suggests that malignant erythema may serve as a valuable clinical indicator for malignancy risk and a useful complement to anti-TIF-1 γ antibody testing.

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BibTeX
@article{xing2026malignant,
  title = {{Malignant erythema as a high-specificity cutaneous indicator of malignancy in adult dermatomyositis: a retrospective cohort study}},
  author = {Xiaojing Xing and Zihang Li and Biwen Lin},
  journal = {Frontiers in immunology},
  year = {2026},
  month = sep,
  doi = {10.3389/fimmu.2026.1960856},
  url = {https://europepmc.org/article/PMC/PMC13661934},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Malignant erythema as a high-specificity cutaneous indicator of malignancy in adult dermatomyositis: a retrospective cohort study
AU  - Xiaojing Xing
AU  - Zihang Li
AU  - Biwen Lin
PY  - 2026
DA  - 2026/09/30
JO  - Frontiers in immunology
DO  - 10.3389/fimmu.2026.1960856
UR  - https://europepmc.org/article/PMC/PMC13661934
AB  - Background: Dermatomyositis (DM) is associated with a substantially elevated risk of malignancy, yet the cutaneous features predictive of cancer risk in adults remain insufficiently defined.  Objectives: This study aimed to characterize cutaneous manifestations and clinical factors associated with malignancy in adult DM, with a focus on malignant erythema.  Methods: This retrospective cohort study included 261 adults with DM admitted between 2016 and 2023 and followed up till June 2025. Clinical data, laboratory indicators (including creatine kinase [CK] and lactate dehydrogenase [LDH]), autoantibodies, and skin findings were systematically evaluated. The primary outcome was the occurrence of malignant tumors.  Results: Twenty‑six patients (10%) developed malignancy. Malignant erythema was identified in 35 patients (13.3%), among whom 14 (40%) had malignancy. Both anti-transcription intermediary factor-1 γ (anti-TIF-1 γ) antibodies and malignant erythema were independently associated with malignancy (odds ratio [OR] = 18.231, 95% confidence interval [CI] 4.568–72.756, P < 0.001; OR = 17.588, 95% CI 2.151–143.824, P = 0.007). Malignant erythema demonstrated higher specificity for tumor prediction than anti-TIF-1 γ antibodies (91.1% vs. 86%, P < 0.001), while sensitivity did not differ significantly (53.8% vs. 73.1%, P = 0.190). while.  Conclusion: Malignant erythema is a distinctive poikilodermatous manifestation strongly associated with malignancy in adult DM. Its high specificity suggests that malignant erythema may serve as a valuable clinical indicator for malignancy risk and a useful complement to anti-TIF-1 γ antibody testing.
SN  - 1664-3224
ER  -