510 Clinical features, time to diagnosis, and time to comorbidity screening in a diverse cohort of patients with clinically amyopathic dermatomyositis

Clinically amyopathic dermatomyositis (CADM) can be challenging to diagnose due clinicopathologic overlap with other skin rashes and potentially subtle examination findings in patients darker skin. The degree which a patient’s color impacts clinical presentation of CADM, time diagnosis, screening for comorbidities such as malignancy interstitial lung disease (ILD) has not been studied in-depth dermatomyositis. To investigate this question, we identified 75 CADM at Johns Hopkins from 2000-present retrospectively gathered data on Fitzpatrick type, presentation, symptoms diagnosis cancer ILD screening. 54 had type I-III 21 IV-VI. Overall was 17.9 months (range 0.2-120 months) overall 52 days 0-300 days). 5 an associated systemic malignancy. Skin vs. IV-VI included: heliotrope rash 52% 65% (p=0.43), Gottron papules 76% 75% (p=1), sign 50% 60% (p=0.6), Holster 15% 30% (p=0.18), V-neck Shawl 44% 70% (p=0.07), periungual erythema 80% (p=0.75), mechanic’s hands 35% (p=0.78), scalp 33% (p=0.15), calcinosis cutis 17% ulcerations 11% 20% (p=0.44). In IV-VI, 19 16 (p=0.79), 52.6 54.3 285 94 (p=0.29). Overall, presented similar regardless type. We are currently investigating factors related unusual presentations delayed individual patients.