{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:27:28Z","timestamp":1791214048886,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,12,15]],"date-time":"2015-12-15T00:00:00Z","timestamp":1450137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The course of dermatomyositis (<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>) can be chronic with relapses, which are associated with major morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to identify presentation features that predict <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> relapses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed data of patients with <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> recorded from 1990 to 2011, including muscle biopsy results. Characteristics of patients with and without relapses were compared. Hazard ratios (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>s) were estimated using a Cox model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 34 patients, with a mean age of 46 \u00b1 17 years (range, 18\u201377) and 24 (71%) women. The muscle and skin abnormalities relapsed in 21 (61%) patients. By univariate analysis, two presentation features were significantly associated with a subsequently relapsing course, namely, dysphonia [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> = 3.2 (1.2\u20138.5)] and greater skin lesion severity defined as a Cutaneous Disease Area Severity Index [<jats:styled-content style=\"fixed-case\">CDASI<\/jats:styled-content>] &gt; 20 [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> = 3.5 (1.2\u20137.9)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dysphonia and skin lesion severity at disease onset must be recorded, as they significantly predict a relapsing disease course.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.13516","type":"journal-article","created":{"date-parts":[[2015,12,16]],"date-time":"2015-12-16T03:04:37Z","timestamp":1450235077000},"page":"813-818","source":"Crossref","is-referenced-by-count":17,"title":["Dermatomyositis: factors predicting 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