Dermatomyositis is an uncommon medical condition that occurs in approximately 10 in a million people. It is characterized by muscle weakness and a specific rash on the skin. Dermatomyositis affects the tissues and blood vessels surrounding the muscles, affecting the strength of the muscles and inflammation of the skin. The condition can develop in both adult and children. In adults, it is most prevalent between the ages of 40 and 60, and in children, it shows up between the ages of 5 and 15. It is more common in females than males. There is no cure for dermatomyositis, but with treatment, symptoms can be managed.
What Are the Causes and Complications of Dermatomyositis?
Dermatomyositis has no known cause. Researchers have found many similarities between dermatomyositis and autoimmune diseases, as both affect connective tissues and involve immune cells attacking healthy tissues in the body. Patients with autoimmune disorders or a compromised immune system are at higher risk of developing dermatomyositis.
Complications of dermatomyositis include:
- Difficulty swallowing: The muscles in your esophagus can be affected and you can have problems swallowing (dysphagia). This can cause weight loss and malnutrition.
- Aspirational pneumonia: If dermatomyositis causes difficulty swallowing, it can also cause you to breathe in food or liquids.
- Breathing problems: The condition can affect your chest muscles and cause you to develop breathing problems, such as shortness of breath.
- Calcium deposits: These can occur in your muscles, skin, and connective tissues as dermatomyositis progresses. Calcium deposits are more common in children and develop earlier in the course of the disease.
Symptoms of Dermatomyositis
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Dermatomyositis develops slowly. The small blood vessels found in muscle tissues are most affected by dermatomyositis. The vessels become surrounded by inflammatory cells, which eventually cause destruction of the muscle fibers. The first sign of the condition is often a small red and patchy rash. Some patients develop a rash that is blue or purple in color. The rash often develops across the shoulders and upper back, over the knuckles, on the palms and fingers, over the elbows and knees, around the eyes, and on the upper chest in a ‘v’ shape.
Eventually, muscle weakness will develop. It may occur weeks or months after the condition first appears. The muscles affected are those closest to the torso, including the hips, thighs, shoulders, upper arms, and neck. Other common symptoms of dermatomyositis include difficulty rising from a sitting to standing position, unexplainable core weakness, pain or weakness in the joints, problems swallowing, unexplainable weakness, and fatigue even after resting.
How to Diagnose Dermatomyositis
A doctor will begin by examining the patient, their skin, any rashes, and asking questions about their symptoms. Once dermatomyositis is discovered as a potential condition, the doctor will perform additional tests to confirm the diagnosis.
Blood tests can reveal elevated levels of muscle enzymes, which can indicate muscle damage. A chest x-ray may be performed if lung damage is suspected in association with dermatomyositis. An electromyography can test the function of the muscles and reveal the presence of muscle damage. An MRI can show various cross-sections of a patient’s muscles, showing any damage that may be present. A doctor may also order a biopsy of a patient’s skin or muscles to have them tested for the disease.
What Are the Treatment Options for Dermatomyositis?
Although there is no cure for dermatomyositis, treatments can help to relieve symptoms. Corticosteroids can be prescribed to help decrease inflammation in the skin and muscles. For rashes that are extra persistent, doctors may prescribe antimalarial medications. Wearing sunscreen is vitally important for patients with dermatomyositis to protect their skin from further sun damage.
Physical therapies, including speech therapy, may help patients deal with muscular effects of the medical condition. Physical therapy can help to strengthen muscles that have been weakened by the condition. Speech therapy can help those patients suffering from trouble swallowing.
If calcium deposits become a persistently painful issue for a patient suffering from dermatomyositis, surgery may be the only option for removing them.
Tips for Dermatomyositis Patients
Understanding dermatomyositis and knowing how the condition affects you as a patient is incredibly important for developing a treatment plan and coping strategy. It is a good idea to maintain a healthy lifestyle when suffering from dermatomyositis, including eating a healthy diet and exercising regularly. Most crucial, listen to your body and know yourself. When you are tired, make sure to get enough rest, as not to strain your muscles further.
Dermatomyositis Diet and Exercises
Due to the increased inflammation caused by dermatomyositis, patients should consume a diet high in protein. Protein has anti-inflammatory effects and muscle-building capabilities. Patients with difficulty swallowing should avoid eating before going to sleep. Junk foods should be avoided as well as foods high in salt. Patients with difficulty swallowing may want to consume softer, easier to swallow foods. They may also want to drink liquids in between bites.
Dermatomyositis patients should remain as active as they can, keeping in mind their physical limitations. Extreme physical exertion should be avoided, but physical activity is important for maintaining muscle strength. Depending on the severity of the patient’s muscular weakness, different exercise regimes may be recommended.
Prognosis of Dermatomyositis
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There is no definitive prognosis of dermatomyositis. A patient’s medical outlook with dermatomyositis is highly dependent on when the condition is diagnosed and what the associated symptoms are. Children who are diagnosed with dermatomyositis often show full remission of symptoms when they get older. This is less common in adults diagnosed with the condition. The severe muscle weakness can lead to malnutrition, pneumonia, and respiratory failure. If the disease affects a patient’s heart or lungs, prognosis is less positive.
Dermatomyositis is an extremely rare inflammatory condition that develops over time. It can occur in both children and adults but is most prevalent in women between the ages of 40 and 60. The condition affects the blood vessels and tissues in and around the muscles. It causes muscle weakness and a red rash, though some patients complain of a blue or purple rash. There is no cure for dermatomyositis and early detection is crucial to treatment of the condition. Children are more likely to have full remission of symptoms than adults, but adults can manage symptoms with a regular treatment plan.
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