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Refractory DM Skin Disease — SCE Rheumatology MCQ

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HardMyositisRefractory DM Skin DiseaseSCE Rheumatology

A 57-year-old with new anti-TIF1-gamma-positive dermatomyositis has no cancer found on baseline enhanced screening. What additional surveillance is recommended for this high-risk phenotype?

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Correct answer: B — Repeat basic screening annually for the next three years

Age over 40 and anti-TIF1-gamma positivity place this patient in a high-risk IIM group. IMACS recommends basic and enhanced screening at diagnosis, followed by basic screening annually for three years; additional imaging such as PET-CT is conditional when baseline assessment is unrevealing and suspicion remains high.

Reference: IMACS international guideline for inflammatory-myopathy-associated cancer screening (Published November 2023): https://www.nature.com/articles/s41584-023-01045-w; BSR guideline for idiopathic inflammatory myopathy in children and adults (Published April 2022): https://academic.oup.com/rheumatology/article/61/5/1760/6555980