A case of anti-SAE antibody-positive dermatomyositis presenting with preceding panniculitis as the initial symptom

Myositis-specific autoantibodies found in dermatomyositis (DM) are associated with clinical symptoms and responses to therapy and are useful for diagnosis, treatment selection, and prognostication. Although the prevalence of anti-small ubiquitin-like modifier-activating enzyme (anti-SAE) antibodies in DM patients is low, clinical features such as skin symptoms preceding muscle symptoms and a higher incidence of dysphagia and malignancy have been reported. Herein, we present a case of anti-SAE antibody-positive DM in which panniculitis of the lower legs, a rare dermatological manifestation of DM, preceded muscle symptoms by 2 months. This case was associated with cervical cancer; however, the clinical course of DM was favourable with glucocorticoid monotherapy. Anti-SAE antibody-positive DM needs to be considered as a differential diagnosis of unexplained panniculitis without muscle symptoms.