Dermatomyositis: What are its symptoms, causes and treatment (1)

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Dermatomyositis
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Dermatomyositis

• Dermatomyositis is a disease of the
  connective-tissue which is defined by swelling of
  the skin and muscles. This condition affects
  adults and children however it is more common in
  females than males. It mostly affects the skin
  and muscles, but it may also affect the lungs and
  oesophagus. Paraneoplastic is a phenomenon that
  develops in the presence of cancer, usually
  pre-existent ones. In such cases, the removal of
  the cancerous growth results in dermatomyositis.
  The condition, on diagnosis, discloses dystrophic
  calcification of muscles and sometimes calcium
  deposits under the skin. The accompanying rash
  appears and disappears with topical applications,
  but the Gottron's papules, pink knuckle patches,
  and priapism are unmistakable symptoms. This
  malady is studied in relation to polymyositis and
  body myositis. When the condition strikes
  children, it is referred to as juvenile
  dermatomyositis (JDM).

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What are the causes of Dermatomyositis

• The cause of dermatomyositis is not known yet
  however, research reveals that it could be
  associated with a viral infection or some
  autoimmune reaction. There have been a number of
  cases in which the condition has developed in the
  presence of autoimmune diseases such as
  scleroderma, lupus or vasculitis. The link
  between dermatomyositis and autoimmune disease
  has been established beyond doubt and is the main
  reason for the preference of antinuclear antibody
  tests for proper diagnosis.

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Symptoms

• Skin rash
• Symmetric proximal muscle weakness
• Muscle pain
• Temporary paralysis
• Difficulty in swallowing
• Scaly skin eruption
• Flat, erythematous lesion on the shoulders and
  chest
• Periungual telangiectasias
• Erythema
• Psoriasiform scalp changes
• Gastrointestinal infection
• Lung problems

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Treatments

• Muscle fascicles, surrounded by shrunken
  polygonal muscle fibres
• Mature lymphocytes, with scant cytoplasm and dark
  nuclei
• B- and T-cells in equal numbers
• Damaged microscopic vessels and lymphocytic
  inflammation
• Tissue ischemia
• Dominant lymphocyte myopathies, inflammatory in
  nature
• This condition can be treated with the help
  of prednisone, plasmapheresis, IVIG (intravenous
  immunoglobulin), and chemotherapy. Today, there
  are a number of immune-modulating drugs available
  to address the onset of this condition. Before
  the treatment, a thorough diagnosis of the
  condition with the help of EMG (electromyography),
  muscle biopsy, and a number of other
  prescribed blood testsis done. The muscle biopsy
  results usually highlight either mixed B and
  T-cell perivascular infiltrate or perifascicular
  muscle atrophy.

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Treatments
Continue

• The condition is commonly associated with
  auto-antibodies like anti-Jo1. Dermatomyositis is
  also treated with the help of orthotic devices.
  Options like intravenous immunoglobulin,
  immunosuppressants, and topical corticosteroids
  are a part of the treatment.
• Corticosteroids help to suppress the immune
  system and limit antibody production. This helps
  in reducing the painful muscle and skin
  inflammation. However, prolonged corticosteroid
  usage results in osteoporosis, weight gain, and
  diabetes. The immunosuppressant treatment option
  includes the administration of drugs such
  as azathioprine and methotrexate. Anti-malarial
  medication like hydroxychloroquine and
  chloroquine phosphate also helps to ease the
  inflammation. Physiotherapy is also an important
  part of treatment. The exercises are designed
  around the need to improve muscle strength and
  flexibility. Surgery is a treatment option
  resorted only to remove the painful calcium
  deposits. Doctors may also prescribe pain
  relievers and radiation therapy.

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