Dermatomyositis

Description

Dermatomyositis (dur-muh-toe-my-uh-SY-tis) is an uncommon inflammatory disease marked by muscle weakness and a distinctive skin rash.

The condition can affect adults and children. In adults, dermatomyositis usually occurs in the early 40's until the early 60's. In children, it most often appears between 5 and 15 years of age. Dermatomyositis affects more women than men.

There is No cure for dermatomyositis, but periods of symptom improvement can occur. The treatment can help to clear the rash of the skin and help you regain muscle strength and function.

Symptoms

The signs and symptoms of dermatomyositis can occur suddenly or develop gradually over time. The most common signs and symptoms include:

  • Changes in the skin. Violet, dark-colored or red rash develops, most commonly on the face and on the eyelids and on the knuckles of the fingers, elbows, knees, chest, and back. The rash, which may be itchy and painful, it is often the first sign of dermatomyositis.
  • The muscle weakness. Progressive muscle weakness involves the muscles closest to the trunk, such as those in the hips, thighs, shoulders, upper arms and neck. The weakness affects both the left and right sides of his body, and tends to get worse with time.

When to see a doctor

Seek medical attention if you develop muscle weakness, or an unexplained rash.

Causes

The cause of dermatomyositis is unknown, but the disease has much in common with autoimmune disorders, in which your immune system mistakenly attacks the tissues of your body.

Genetic and environmental factors may also play a role. Environmental factors can include viral infections, sun exposure, certain medications, and smoking.

Risk factors

While any person can develop dermatomyositis is more common in people assigned female at birth. The genetic and environmental factors, including viral infections and exposure to sun can also increase the risk of development of dermatomyositis.

Complications

The possible complications of dermatomyositis are:

  • Difficulty swallowing. If the muscles in the esophagus are affected, may have problems of swallowing, which may cause weight loss and malnutrition.
  • Aspiration pneumonia. Difficulty swallowing can also make your breathing food or liquid, including saliva, in her lungs.
  • Breathing problems. If the disease affects the muscles of the chest, andou could have breathing problems, such as shortness of breath.
  • The calcium deposits. These can occur in the muscles, skin, and connective tissues, as the disease progresses. These deposits are more common in children with dermatomyositis and develop early in the course of the disease.

Associated conditions

Dermatomyositis may cause other conditions or put you at higher risk of developing them, including:

  • Raynaud's phenomenon. This condition causes your fingers, toes, cheeks, nose, and ears to pale when exposed to cold temperatures.
  • Other connective tissue diseases. Other conditions — such as lupus, rheumatoid arthritis, scleroderma, and Sjogren's syndrome — can occur with dermatomyositis.
  • Cardiovascular disease. Dermatomyositis may cause the heart muscle is inflatedmmation. In a small number of people who have dermatomyositis, congestive heart failure and heart rhythm problems develop.
  • The lung disease. Interstitial lung disease can occur with dermatomyositis. Interstitial lung disease refers to a group of disorders that cause scarring of the lung tissue, making the lungs stiff and inelastic. The signs include a dry cough, and difficulty breathing.
  • Cancer. Dermato -myositis in adults has been linked to an increased likelihood of developing cancer, especially ovarian cancer in women. The risk of cancer appears at the level of three years or so, after a diagnosis of dermatomyositis.

Dermatomyositis

Diagnosis

If your doctor suspects that has dermatomyositis, he or she may suggest some of the following tests:

  • The analysis of blood. A blood test will let your doctor know if you have elevated levels of muscle enzymes that can indicate muscle damage. A blood test can also detect autoantibodies associated with different symptoms of dermatomyositis, which can help in determining the best medication and treatment.
  • X-ray of the chest. This simple test can check for signs of the type of lung damage that sometimes occurs with dermatomyositis.
  • Andlectromyography. A doctor with specialized training and inserts a thin needle electrode through the skin into the muscle to be tested. The electrical activity is measured as you relax or tighten the muscles, and changes in the pattern of electrical activity can withthe signing of a muscle disease. The doctor can determine which muscles are affected.
  • The magnetic resonance imaging. A scanner creates cross-sectional images of the muscles of the data generated by a powerful magnetic field and radio waves. Unlike a muscle biopsy, an mri can assess inflammatiin more of a large area of muscle.
  • Skin or muscle biopsy. A small piece of skin or muscle is removed for laboratory analysis. A sample of the skin can help to confirm the diagnosis of dermatomyositis. A muscle biopsy may reveal inflammation in the muscles or other pos problems, such as damage or infection. If the biopsy confirms the diagnosis, a muscle biopsy may not be necessary.

Treatment

There is No cure for dermatomyositis, but treatment can improve your skin and your muscle strength and function.

Drugs

Medications used for the treatment of dermatomyositis are:

  • Corticosteroids. Medications such as prednisone (Rays) can control the dermatomyositis symptoms quickly. But prolonged use can have serious side effects. So the doctor, after the prescription of a relatively high dose to control your symptoms, you can reduce the dose gradually as its symptoms to improve.
  • Corticosteroid-sparing agents. When used with a corticosteroid, these medicines can decrease the dose and the side effects of corticosteroids. The two most common medicines for dermatomyositis are azathioprine (Azasan, Imuran) and methotrexate (Trexall). Mycophenolate mofetil (Cellcept) is another drug used for the treatment of dermatomyositis, especially if the lungs are involved.
  • Rituximab (Rituxan). Most commonly used to treat rheumatoid arthritis, rituximab is an option if the initial therapies do not control your symptoms.
  • Anti-malarial drugs. For a rash, persistent, your doctor might prescribe a medication against malaria, such as hydroxychloroquine (Plaquenil).
  • The sunscreens. Protect your skin from sun exposure by applying sunscreen and wearing protective clothing and hats is important for the management of the rash of dermatomyositis.

Therapy

Depending on the severity of your symptoms, your doctor may suggest:

  • The physical therapy. A physical therapist can show you exercises to help you maintain and improve your strength and flexibility, and advise you on an appropriate level of activity.
  • Speech therapy. If your swallowing muscles are affected, speech therapy can help you learn how to compensate for these changes.
  • Dietary assessment. Later in the course of dermatomyositis, chewing and swallowing may be more difficult. A registered dietitian can teach you how to prepare easy-to-eat foods.

Surgical and other procedures

  • Intravenous immunoglobulin (Ivig). IVIg is purified of the blood product that contains healthy is antibodies of thousands of blood donors. These antibodies can block the harmful antibodies that attack the muscle and skin in dermatomyositis. Given as an infusion through a vein, Ivig treatments are expensive and may need to be repeated regularly for the purposes of continue.
  • Surgery. Surgery may be an option to remove painful calcium deposits and avoid the recurrence of skin infections.

Self-care

With dermatomyositis, the areas affected by the eruption are more sensitive to the sun. Use protective clothing or high-pl a protective sunscreen when you go out on the street.

Coping and support

Living with a chronic autoimmune disease can make you question if you are prepared for the challenge. To help deal with the situation, try the following:

  • To know of their disease. Read everything you can about dermatomyositis and other muscle and autoimmune disorders. Talk to people who have a similar condition. Don't be afraid to ask your doctor questions about your disease, the diagnosis or plan of treatment.
  • Be a part of his doctor of team. Considered to you, your doctor and other medical experts involved in your care, as a united front in the management of their disease. Follow the treatment plan agreed upon, it is of vital importance. Keep your doctor informed of any new signs or symptoms that you have.
  • Get active. A regular routine of exercises can help you build and maintain your muscle strength. Make sure you get a detailed plan and recommendations of your doctor or physical therapist before beginning an exercise program.
  • Rest when you are tired. Do not wait for the ununtil you're exhausted. This will only cost you more as your body tries to recover. Learning to pace yourself can help you to maintain a constant level of power, accomplish just as much, and feel better emotionally.
  • Acknowledge your emotions. The denial, the anger and frustration are normal when it comes with dermatomyositis. The feelings of fear and isolation are common, so stay close to your family and friends. Try to keep your daily routine as best you can and do not forget the things that you enjoy. Many people find support groups helpful.

Preparing for your appointment

It is likely that you first see your family doctor, who might refer you to a doctor who specializes in the treatment of arthritis and other diseases of the joints, muscles and bones (rheumatologist) and a medical doctor who specializes in skin diseases (dermatologist).

What you can do

Make a list that includes:

  • Detailed descriptions of your symptoms and when they began
  • Information about the medical problems you have had, and those of their parents or siblings
  • All the drugs and supplements you take and their dosages
  • Questions to ask the doctor

Have a friend or family member, if possible, to help you remember the information they give you.

For dermatomyositis, questions to ask your doctor include:

  • Whis likely causing my symptoms?
  • What are other possible causes?
  • Are my symptoms can change over time?
  • What tests might I need? Are the special preparations required?
  • Are the available treatments for my condition? What treatments are recommended?
  • I have ottheir medical conditions. How can I best manage them together?
  • Do you have brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor will likely ask you questions, such as:

  • Did your condition develop gradually or suddenly?
  • You're easy-to-fatigue during waking hours?
  • Does your condition limit your activities?
  • Has someone in your family has been diagnosed with a condition that affects the muscles?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Dermatomyositis