Dermatomyositis is an inflammatory condition which commonly features with muscle weakness and characteristic skin rash. The symptoms and signs of dermatomyositis develop gradually over weeks or even months. Dermatomyositis may affect people of all ages. Still, it is most frequent in people in late 40s and early 60s. It is also common for children between the age of 5 and 15. This condition predominantly affects women.
Dermatomyositis - Causes
This disease belongs to a group of so called myopathies. The exact cause of most myopathies is still unknown. Some assume that the inflammation may be associated with infections (bacterial, parasitic or viral infections). Others believe in genetic susceptibility to dermatomyositis. This condition has many characteristics of autoimmune diseases. Namely, the immune system produces autoantibodies which destroy body's own cells. In this medical condition the process of inflammation particularly affects small blood vessels in muscular tissue. In majority of patients there are circulating antibodies which can be easily detected.
Dermatomyositis - Symptoms
The inflammation typically affects the skin and the muscles. The skin is violet-colored or it may be covered in dusky red rash. The rash predominantly develops on the face and eyelids, around the nails, on knuckles, elbows, knees, chest and back. The rash can be patchy and in some patients there are bluish-purple discolorations.
The affected muscles become weak and the weakness is progressive. The most commonly affected muscles are those closest to the trunk (hip, thigh, shoulder, neck and upper arm muscles). Apart from being weak muscles may be painful and tender as well.
Additional symptoms of dermatomyositis include fatigue, fever and weight loss. Furthermore, the patients may suffer from lung problems, dysphagia, gastrointestinal ulcers and calcinosis.
There is no definitive cure for dermatomyositis. However, there are several treatment options which can sucessfully alleviate the symptoms, improve the skin appearance, strengthen the muscles and stop the progression of the disease. Timely treatment reduces a chance of serious complications.
Medications prescribed to patients suffering from dermatomyositis include corticosteroids which are commonly prescribed together with corticosteroid-sparing agents. Corticosteroids are highly efficient in suppression of the immune system. They limit the production of antibodies and consequently reduce skin and muscle inflammation. Corticosteroid-sparing agents are necessary particularly in patients who are under prolonged therapy with corticosteroids. They decrease side effects of corticosteroids.
If there is no desirable response to corticosteroids patients may be treated with immunosupressants, antimalarial medications and pain relievers. In some cases patients are administered intravenous immunoglobulin (IVIg).
Apart from medicamentous therapy patients suffering from dermatomyositis may additionally benefit from physical therapy and speech therapy. And surgery is reserved only if there is calcinosis or to solve problem of recurrent skin infections.