Dermatomyositis is a very uncommon inflammatory condition. A characteristic skin rash and inflammatory myopathy, or inflamed muscles, producing muscle weakness, are common symptoms. It’s one of just three inflammatory myopathies that have been identified.
Adults and children can both be affected by dermatomyositis. Although there is no treatment for this illness, the symptoms can be treated.
Dermatomyositis (dur-muh-toe-my-oh-SY-tis) is a rare inflammatory illness characterised by muscle weakness and a unique rash.
Adults and children are also susceptible to the disease. Dermatomyositis strikes individuals in their late 40s to early 60s. It usually arises in children between the ages of 5 and 15. Dermatomyositis is more common in women than in men.
Dermatomyositis has no treatment, but it does have phases of symptom relief. The right treatment might help you get rid of the rash and regain muscular strength and function.
What are the signs and
symptoms of Dermatomyositis?
What are the signs and symptoms of Dermatomyositis?
A unique skin rash on the cheeks, eyelids, chest, nail cuticle areas, knuckles, knees, or elbows is usually the initial symptom. The rash is frequently spotty and bluish-purple in hue.
Because it occurs in a shawl-like pattern, a rash on the chest is described as a “shawl sign.” Because it makes the skin appear rough and unclean, a rash on the hands is known as “mechanic’s hands.”
Muscle weakness that worsens over weeks or months is also possible. Muscle weakness typically begins in the neck, arms, or hips and affects both sides of the body.
Other signs and symptoms to look out for include:
- Muscle pain
- Muscle tenderness
- Problems swallowing
- Lung problems
- Hard calcium deposits underneath the skin, which are mostly seen in children
- Unintentional weight loss
Dermatomyositis has a variant that contains the rash but not the muscle weakening. Amyopathic dermatomyositis is the medical term for this condition.
What Causes Dermatomyositis?
Dermatomyositis’ actual cause is unknown. It does, however, have many characteristics of an autoimmune disease.
When your body’s disease-fighting cells, called antibodies, assault your healthy cells, you have an autoimmune illness. A weakened immune system may also play a role in the development of the disease.
A viral infection or malignancy, for example, can damage your immune system and cause dermatomyositis to develop.
About 15 to 30 percent of dermatomyositis instances are linked to cancers of the breast, ovarian, or lung. This is known as paraneoplastic dermatomyositis, which means the condition is linked to a tumour but not caused by it.
How is It
How is It diagnosed?
Your doctor will examine you and ask you questions about your symptoms and medical history. Because of the autoimmune rash associated with dermatomyositis, it is a simpler inflammatory muscle condition to identify.
Your doctor may also issue the following orders:
- An MRI. A scanner uses data generated by a high magnetic field and radio waves to make cross-sectional images of your muscles. An MRI, unlike a muscle biopsy, can measure muscular inflammation across a vast area.
- Electromyography (EMG). A specialist doctor inserts a small needle electrode into the muscle to be checked via the skin. When you relax or tense a muscle, electrical activity is monitored, and alterations in the pattern of electrical activity can confirm a muscle condition. The doctor will be able to tell you which muscles are impacted.
- Blood analysis. If you have elevated levels of muscle enzymes, which can suggest muscle injury, a blood test will tell your doctor. A blood test can also discover autoantibodies linked to various dermatomyositis symptoms, which can aid in the selection of the optimal medicine and treatment.
- Muscle or skin biopsy. For laboratory analysis, a small sample of skin or muscle is taken. Dermatomyositis can be diagnosed with the use of a skin sample. A muscle biopsy may identify muscle inflammation or other issues such as injury or infection. A muscle biopsy may not be necessary if the diagnosis is confirmed by a skin biopsy.
- Chest X-ray. This simple test can detect evidence of the type of lung damage that dermatomyositis can cause.
What are the Risks & Complications?
What are the Risks & Complications?
Dermatomyositis can affect anyone. Adults between the ages of 40 and 60, as well as children between the ages of 5 and 15, are the most affected.
Dermatomyositis has a reported incidence of 9.63 cases per million individuals. Symptoms in youngsters commonly occur between the ages of five and fifteen. Juvenile dermatomyositis affects about three out of every one million children. Dermatomyositis affects women twice as much as it does men.
Dermatomyositis can lead to the following complications:
- Swallowing problems. You may have difficulty swallowing if the muscles in your oesophagus are compromised, which can lead to weight loss and malnutrition.
- Pneumonia caused by aspiration. Food or liquids, including saliva, can get into your lungs if you have trouble swallowing.
- Breathing difficulties. If your chest muscles are affected, you may experience breathing difficulties such as shortness of breath.
- Deposits of calcium. As the disease advances, these can arise in your muscles, skin, and connective tissues. Children with dermatomyositis are more likely to develop these deposits, which appear earlier in the disease’s course.
Dermatomyositis may cause or increase your risk of developing other conditions, such as:
- Raynaud’s syndrome. A condition in which the blood vessels in the hands and feet become cold When exposed to cold temperatures, this ailment causes your fingers, toes, cheeks, nose, and ears to turn pale.
- Other disorders of the connective tissue. Dermatomyositis can be accompanied by other diseases such as lupus, rheumatoid arthritis, scleroderma, and Sjogren’s syndrome.
- Cardiovascular disease. Dermatomyositis can irritate the heart muscle. Congestive heart failure and cardiac rhythm issues occur in a small percentage of persons with dermatomyositis.
- Lung disease. Dermatomyositis can cause interstitial lung disease. Interstitial lung disease is a set of illnesses characterised by scarring of lung tissue, which causes the lungs to become rigid and inelastic. A dry cough and shortness of breath are two symptoms.
- Cancer. Dermatomyositis has been related to an increased risk of cancer in adults, especially ovarian cancer in women. Three years following a diagnosis of dermatomyositis, the risk of cancer appears to level off.
What are the
What are the treatment options?
Dermatomyositis is no cure, however, treatment can help your skin as well as your muscular power and function.
Dermatomyositis is treated with the following medications:
- Corticosteroid-sparing agents. When used with a corticosteroid, these medications can reduce the corticosteroid’s dose and negative effects. Azathioprine (Azasan, Imuran) and methotrexate are the two most used treatments for dermatomyositis (Trexall). Another medicine used to treat dermatomyositis is mycophenolate mofetil (Cellcept), which is especially effective if the lungs are implicated.
- Intravenous immunoglobulin (IVIG). Your body produces antibodies that attack your skin and muscles if you have dermatomyositis. Healthy antibodies are used in intravenous immunoglobulin (IVIG) to inhibit these antibodies. IVIG is made up of a combination of antibodies collected from thousands of healthy people who have donated blood. Antibodies are administered through an IV.
- Corticosteroids. Dermatomyositis symptoms can be controlled promptly with drugs like prednisone (Rayos). However, long-term use can have catastrophic consequences. As a result, your doctor may gradually reduce the amount as your symptoms improve after prescribing a relatively high dose to control your symptoms.
- Antimalarial medications. Your doctor may prescribe an antimalarial medicine, such as hydroxychloroquine if the rash persists (Plaquenil).
- Rituximab (Rituxan). Rituximab, which is more frequently used to treat rheumatoid arthritis, is a possibility if your symptoms aren’t controlled by other treatments.
- Sunscreens. The rash of dermatomyositis can be managed by applying sunscreen and wearing protective clothing and headgear to protect your skin from the sun.
Your doctor may recommend the following treatments, depending on the severity of your symptoms:
- Physical therapy. A physical therapist may show you exercises to help you maintain and increase your strength and flexibility, as well as give you advice on how much activity is acceptable for you.
- Speech therapy. Chewing and swallowing can become more difficult as dermatomyositis progresses. You can learn how to make simple dishes from a licenced dietician.
Alternative and Complementary therapies used
when treating Dermatomyositis patients
Although dermatomyositis can be treated in about 20% of individuals who have it, it is not curable in the majority of cases. The symptoms, on the other hand, are treatable. Your doctor will devise a treatment plan to assist you in managing your symptoms.
Furthermore, many persons with dermatomyositis and other kinds of myositis have benefited from healthy living choices.
Regular exercise and an anti-inflammatory diet that includes plenty of fruits and vegetables while avoiding items like processed meats and sugary desserts are two of these behaviours.