December 29, 2025
2 min read
Key takeaways:
- Dermatomyositis complications can lead to hospitalization.
- Certain presentations upon hospitalization can increase risks for in-hospital mortality.
Active rash, interstitial lung disease and elevated neutrophil to lymphocyte ratio were independently associated with in-hospital mortality among patients with dermatomyositis, according to a study.
“Dermatomyositis is a multisystem disease, and skin is one of the organs that is very frequently affected,” Jun Kang, MD, assistant professor of dermatology at Johns Hopkins University School of Medicine, told Healio. “These patients can also get lung disease and, unfortunately, get very sick and die.”
For many people with dermatomyositis, hospitalization due to symptom exacerbation, comorbidities or treatment-related complications results in poorer outcomes than those without dermatomyositis, Kang and colleagues wrote.
For the retrospective study, researchers evaluated adults with preexisting dermatomyositis who were admitted to Johns Hopkins Hospital for any cause from January 2013 to May 2024.
Among the 153 patients (mean age, 56.5 years; 73.9% women) with dermatomyositis, 16 (10.5%) died during hospitalization, the majority (n = 9) from interstitial lung disease.
“Not surprisingly, patients who do have interstitial lung disease as a complication of upper meta myositis are at a much higher risk of mortality,” Kang said.
Further, patients who died during hospitalization from dermatomyositis were more likely than survivors to have interstitial lung disease (87.5% vs. 41.6%), which was independently associated with mortality (OR = 6.43; 95% CI, 1.78-23.13; P = .04).
“What was new about the study is that the presence of active rash was also associated with mortality at the end of their hospitalization,” Kang told Healio.
Patients who died were more likely than survivors to have active rash (81.3% vs. 34.3%) when hospitalized. Active rash was also independently associated with mortality (OR = 12.13; 95% CI, 3.18-46.28; P = .003).
“What I found very interesting was that many patients had, concurrently, both the rash as well as interstitial lung disease,” Kang said. “Those patients were also at an increased risk of mortality.”
An elevated neutrophil to lymphocyte ratio was also linked with increased mortality among patients with dermatomyositis who were hospitalized (7.43% vs. 3.83%). The independent relationship between an elevated neutrophil to lymphocyte ratio and mortality amounted to an odds ratio per 1-unit increase of 1.29 (95% CI, 1.16-1.44; P < .001).
Myositis prevalence did not differ significantly between deceased patients and survivors, the researchers wrote.
Recognizing these high-risk features is important and is not a responsibility exclusive to dermatologists and rheumatologists, according to Kang.
“It’s for the internal medicine doctors too, who are seeing a lot of these patients firsthand,” Kang told Healio. “Hospital internists are the ones who might see these patients early on. Understanding these features across diverse groups of doctors is important so that we can identify these patients and treat them better.”
For more information:
Jun Kang, MD, can be reached at jkang60@jhmi.edu.
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