Dermatomyositis

Dermatomyositis is a rare inflammatory disease that causes muscle degeneration. It is marked by muscle weakness and a distinctive skin rash. It is an autoimmune disease that affects both adults and children.

Dermatomyositis affects more women than men.There is no cure for dermatomyositis but patients may experience periods of remission. Several treatments that can clear the skin and increase muscle strength are available.

Signs and symptoms of dermatomyositis include:

• A violet or dusky red rash.
• Mostly on the face, eyelids and areas around the nails, knees, elbows, chest and back.

This rash can also have:

• A patchy bluish purple discoloration.
• Progressive muscle weakness, this weakness affects both sides of the body and tends to worsen gradually with time.

Dermatomyositis is caused when the body produces autoantibodies against muscle and skin cells. Small vessels that supply muscles are usually affected.

Destruction of these vessels leads to muscle degeneration. Like other autoimmune diseases, the exact cause of dermatomyositis is unknown.

The following tests can be used in the diagnosis of dermatomyositis:

• Blood chemistry to check for levels of elevated muscle enzymes such as creatine kinase( CK ) and aldolase. Blood tests can also help doctors to identify the specific autoantibodies associate with the symptoms of dermatpmyositis. This can also help them to determine the best treatment options.
• A simple chest X-ray to check for signs of damage to the lungs.
• Electromyography, where electrodes inserted through the skin to the muscle, are used to measure the electrical activity pf a muscle as the patient relaxes and contracts the muscle.
• Magnetic resonance imaging (MRI) to view the cross-sectional image of muscles. This test can assess inflammation over a large area of muscle.
• Skin or muscle biopsy for laboratory examination. A biopsy can be used to exclude other diseases with similar symptoms.

There is no cure for dermatomyositis, however, there are several treatments that can improve symptoms. They include:

• Medications which can be used to reduce inflammation. Medications used include, corticosteroids such as prednisone and corticosteroid
• Sparing agents such as azathioprine (Azasan, Imuran) and methotrexate (Trexall). Rituximab (Rituxan ) can be given if treatment with corticosteroids or corticosteroid
• Sparing drugs proves to be ineffective. Antimalarial drugs, such as hydroxychloroquine (Plaquenil) can be used for a persistent rash.

Therapy including:

• physical therapy which can help to strengthen and increase to flexibility of muscles and speech therapy which can improve chewing and swallowing in some patients.
• Intravenous immunoglobulins can also be used. These healthy antibodies which are taken from donors can block the damaging action of autoantobodies against muscles and skin. This method of treatment is expensive and requires repeated or regular treatment for it to be effective.
• Surgery may be required in cases where patients have painful calcium deposits.

The following tips can help patients living with dermatomyositis to cope:

• Getting more information about this medical condition
• Following the treatment plan
• Exercising frequently to build muscle strength
• Getting enough rest
• Acknowledging emotions of anger or frustration
• Wearing protective clothing or high protection sunscreen when going outside

Complications of dermatomyositis include:

• Dysphagia (trouble swallowing)
• Aspiration pneumonia
• Breathing problems
• Deposition of calcium in the muscles, skin and connective tissue

Dermatomyositis can cause other conditions such as cardiovascular and lung diseases, cancer and connective tissue diseases like lupus, rheumatoid arthritis and scleroderma.