{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:31:49Z","timestamp":1787772709173,"version":"build-2784847793"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Anti-melanoma differentiation-associated gene-5 antibody (anti-MDA-5 Ab) associated with clinically amyopathic dermatomyositis (CADM) is characterized by vasculopathic ulcers, mechanic\u2019s hands, and progressive interstitial lung disease (ILD). We present a case of 38-year-old female who presented with all these classical clinical features. Her investigations revealed normal serum muscle enzyme levels and the presence of anti-Mi2 and anti-MDA-5 antibodies by immunoblot. Imaging study revealed changes suggestive of ILD. She was treated with rituximab along with oral glucocorticoid and other supportive treatment to which she didn\u2019t respond adequately. Recently, it has been postulated that plasmacytoid dendritic cells produce interferon which is responsible for tissue injury in dermatomyositis (DM). Tofacitinib, by inhibiting JAK-STAT pathway, inhibits downstream cytokines, mainly type 1 interferon. So, we added tofacitinib as adjuvant therapy in our patient. Post-six months of commencement of adjuvant tofacitinib, patient experienced remarkable improvement in cutaneous features as well as in pulmonary fibrosis.<\/jats:p>","DOI":"10.4103\/idoj.idoj_399_23","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T08:30:09Z","timestamp":1725006609000},"page":"823-827","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Favorable Response to Adjuvant Tofacitinib in a Case of Anti-Melanoma Differentiation-Associated Gene-5 Antibody Positive Clinically Amyopathic Dermatomyositis"],"prefix":"10.4103","volume":"15","author":[{"given":"Nayankumar H.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Skin and VD, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jigna K.","family":"Padhiyar","sequence":"additional","affiliation":[{"name":"Department of Skin and VD, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahnvi R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Skin and VD, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keval V.","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,4,23]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1001\/archdermatol.2009.328","article-title":"Incidence of dermatomyositis and clinically amyopathic dermatomyositis: A population-based study in Olmsted County, Minnesota","volume":"146","author":"Bendewald","year":"2010","journal-title":"Arch Dermatol"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s12016-020-08822-5","article-title":"Interstitial lung disease in anti-MDA5 positive dermatomyositis","volume":"60","author":"Wu","year":"2021","journal-title":"Clin Rev Allergy Immunol"},{"key":"R3-20240830","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12016-015-8510-y","article-title":"A comprehensive overview on myositis-specific antibodies: New and old biomarkers in idiopathic inflammatory myopathy","volume":"52","author":"Satoh","year":"2017","journal-title":"Clin Rev Allergy Immunol"},{"key":"R4-20240830","doi-asserted-by":"crossref","first-page":"833114","DOI":"10.3389\/fmed.2021.833114","article-title":"Pathogenesis of anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A concise review with an emphasis on type I interferon system","volume":"8","author":"Hu","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"R5-20240830","first-page":"318","article-title":"The mechanism of action of tofacitinib - an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis","volume":"34","author":"Hodge","year":"2016","journal-title":"Clin Exp Rheumatol"},{"key":"R6-20240830","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1007\/s10067-018-4122-2","article-title":"Rituximab for refractory rapidly progressive interstitial lung disease related to anti-MDA5 antibody-positive amyopathic dermatomyositis","volume":"37","author":"So","year":"2018","journal-title":"Clin Rheumatol"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1093\/rheumatology\/key188","article-title":"Tofacitinib for refractory interstitial lung diseases in anti-melanoma differentiation-associated 5 gene antibody-positive dermatomyositis","volume":"57","author":"Kurasawa","year":"2018","journal-title":"Rheumatology (Oxford)"},{"key":"R8-20240830","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1056\/NEJMc1900045","article-title":"Tofacitinib in amyopathic dermatomyositis-associated interstitial lung disease","volume":"381","author":"Chen","year":"2019","journal-title":"N Engl J Med"}],"container-title":["Indian Dermatology Online Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_399_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:09:47Z","timestamp":1787771387000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_399_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,23]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/idoj.idoj_399_23","relation":{},"ISSN":["2229-5178","2249-5673"],"issn-type":[{"value":"2229-5178","type":"print"},{"value":"2249-5673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,23]]},"assertion":[{"value":"2023-05-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}