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We read with interest the article by Sparsa et al¹ entitled "Routine vs Extensive Malignancy Search for Adult Dermatomyositis and Polymyositis" in a recent issue of the ARCHIVES. The authors tried to answer 2 important questions about the management of dermatomyositis: (1) are there predictive factors for malignancy in adult dermatomyositis? and (2) do we have to perform routine or "exhaustive" systematic searches for malignancies? The first question is probably the most important for clinicians because, once we have identified results of clinical or biological examinations predictive of association with cancer, we will be able to perform extensive malignancy search selectively.

Sparsa et al,¹ and Callen² in his editorial in the same issue of the ARCHIVES, underline controversial findings about predictive factors for malignancy in adult dermatomyositis. There are several explanations for this uncertainty: most of the studies are retrospective; there is no clear definition for the paraneoplastic status of . . . [Full Text of this Article]