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Dermatomyositis is a rare inflammatory illness that causes muscular weakness and a unique skin rash.
Both adults and children are susceptible to the illness. Dermatomyositis is most common in people between the ages of 40 and 60. It most commonly appears in youngsters between the ages of 5 and 15. Dermatomyositis affects women more than men.
Dermatomyositis has no cure, but there are times when symptoms improve. Treatment can help you get rid of the rash and improve muscle power and function.
WHAT ARE THE SYMPTOMS OF DERMATOMYOSITIS?
Dermatomyositis symptoms can appear suddenly or develop gradually over time. The following are the most common signs and symptoms:
- Skin changes: A violet-colored or dusky red rash appears on your face and eyelids, as well as your knuckles, elbows, knees, chest, and back. Dermatomyositis is frequently identified by a rash that is itchy and painful.
- Muscle fatigue: The muscles closest to the trunk, such as those in your hips, thighs, shoulders, upper arms, and neck, are affected by progressive muscle weakness. The weakness affects both the left and right sides of your body and worsens over time.
WHAT ARE THE CAUSES OF DERMATOMYOSITIS?
Dermatomyositis has no known cause, but it shares many similarities with autoimmune disorders, in which your immune system mistakenly attacks your body tissues.
Environmental and genetic factors may also play a role. Viral infections, sun exposure, certain medications, and smoking could all be environmental factors.
WHAT ARE THE COMPLICATIONS OF DERMATOMYOSITIS?
Dermatomyositis can lead to the following complications:
- Swallowing difficulty: If the muscles in your esophagus are affected, you may have difficulty swallowing, resulting in weight loss and malnutrition.
- Aspiration pneumonia: Difficulties swallowing can also cause you to breathe food or liquids into your lungs, including saliva.
- Breathing difficulties: If your condition affects your chest muscles, you may experience breathing difficulties, such as shortness of breath.
- Calcium deposits: As the disease progresses, these can occur in your muscles, skin, and connective tissues. These deposits are more common in children with dermatomyositis and appear earlier in the disease's progression.
Associated conditions
Dermatomyositis may cause or increase your risk of developing the following conditions:
- Raynaud's phenomenon: When exposed to cold temperatures, this ailment causes your fingers, toes, cheeks, nose, and ears to turn pale.
- Other connective tissue diseases: Dermatomyositis can be associated with other illnesses such as lupus, rheumatoid arthritis, scleroderma, and Sjogren's syndrome.
- Cardiovascular disease: Dermatomyositis can cause inflammation of the cardiac muscles. Congestive heart failure and cardiac rhythm issues happen in a small minority of persons with dermatomyositis.
- Lung disease: Dermatomyositis can cause interstitial lung disease. Interstitial lung disease is a collection of illnesses that cause lung tissue scarring, leaving the lungs stiff and inelastic. A dry cough and shortness of breath are symptoms.
- Cancer: Dermatomyositis has been related to an increased risk of acquiring cancer in adulthood, notably ovarian cancer in women. Cancer risk tends to level off three years after a diagnosis of dermatomyositis.
HOW IS DERMATOMYOSITIS DIAGNOSED?
If your doctor suspects you have dermatomyositis, he or she may recommend one or more of the following tests:
- Blood analysis: A blood test can tell your doctor if you have high levels of muscle enzymes, which can suggest muscle injury. A blood test can also discover autoantibodies linked to various dermatomyositis symptoms, which can aid in determining the optimal medicine and treatment.
- Chest X-ray: This simple test can detect evidence of the type of lung damage associated with dermatomyositis.
- Electromyography: A doctor with specialized training inserts a thin needle electrode into the muscle to be tested through the skin. When you relax or tighten a muscle, electrical activity is measured, and changes in the pattern of electrical activity can confirm a muscle disease. The doctor will be able to determine which muscles are affected.
- MRI: A scanner uses data generated by a powerful magnetic field and radio waves to create cross-sectional images of your muscles. An MRI, as opposed to a muscle biopsy, can assess inflammation over a large area of muscle.
- Skin or muscle biopsy: A small piece of skin or muscle is removed for testing in the lab. A skin biopsy can aid in the diagnosis of dermatomyositis. A muscle biopsy may reveal inflammation or other issues, such as damage or infection. A muscle biopsy may not be required if the skin biopsy confirms the diagnosis.
WHAT ARE THE TREATMENTS FOR DERMATOMYOSITIS?
Dermatomyositis has no cure, but treatment can improve your skin as well as your muscle strength and function.
Medications
Among the medications used to treat dermatomyositis are:
- Corticosteroids: Dermatomyositis symptoms can be quickly controlled with medications such as prednisone (Rayos). However, long-term use can have serious side effects. So, after prescribing a relatively high dose to control your symptoms, your doctor may gradually lower the dose as your symptoms improve.
- 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 commonly used treatments for dermatomyositis (Trexall). Another medicine used to treat dermatomyositis is mycophenolate mofetil (Cellcept), which is especially effective if the lungs are implicated.
- Rituximab (Rituxan): Rituximab, which is more usually used to treat rheumatoid arthritis, is a choice if first medications do not control your symptoms.
- Medication for malaria: Your doctor may prescribe an antimalarial medicine, such as hydroxychloroquine, if the rash persists (Plaquenil).
- Sunscreens: It is critical to protect your skin from sun exposure by applying sunscreen and wearing protective gear and helmets when dealing with dermatomyositis rash.
Therapy
Your doctor may advise you to do the following, depending on the severity of your symptoms:
- Physiotherapy: A physical therapist can demonstrate exercises that will help you maintain and increase your strength and flexibility, as well as advise you on an acceptable amount of activity.
- Speech therapy: Speech therapy might help you learn how to adjust for changes in your swallowing muscles if they are compromised.
- Dietetic assessment: Chewing and swallowing can become more difficult later in the course of dermatomyositis. A certified dietician can show you how to make simple dishes.
Surgical and non-surgical procedures
- Intravenous immunoglobulin (IVIg): IVIg is a refined blood product containing healthy antibodies derived from thousands of blood donors. In dermatomyositis, these antibodies can inhibit the harmful antibodies that target muscle and skin. IVIg therapies, which are administered as an infusion through a vein, are costly and may need to be repeated on a regular basis for the effects to last.
- Surgery: To remove uncomfortable calcium deposits and avoid recurring skin infections, surgery may be an option.