Dermatomyositis
Dermatomyositis is a connective
tissue autoimmune disorder that causes inflammation
in the muscles and the skin. Dermatomyositis is associated
with another autoimmune condition, called Polymyositis.
Symptoms usually develop over a period of weeks or
months and may include a skin rash, joint pain and
stiffness, trouble swallowing and muscle weakness.
Dermatomyositis can also cause other complications
ranging from mild discomfort to serious conditions,
such as weight loss (when the esophagus muscles are
affected causing difficulty swallowing), breathing
problems when the chest muscles are involved, calcium
deposits in the skin and infections in the lungs and
digestive tract.
Dermatomyositis can be a primary condition or secondary
to other autoimmunes such as Lupus, Mixed Connective
Tissue Disease, Scleroderma or Vasculitis. It can
attack anyone at any age and the exact cause is unknown,
but some experts believe that Dermatomyositis could
be caused by a viral infection in the muscles. Tumors
can also cause Dermatomyositis to trigger.
Other conditions can develop with Dermatomyositis,
and Dermatomyositis can also increase the risk of
more serious conditions. Many Dermatomyositis sufferers
develop Raynaud's Phenomenon, other connective tissue
diseases, cardiovascular diseases, Interstitial Lung
Disease and Dermatomyositis can increase your risk
of cancer. Since there is no cure for Dermatomyositis,
the earlier treatment can be started then the better
the prognosis. Lifestyle adjustments can also improve
the quality of life for Dermatomyositis sufferers,
but left untreated (especially in adults) Dermatomyositis
can be life-threatening if the chest muscles are weakened
and affect the ability to breathe.
Symptoms:
Calcium deposits on bony areas
Difficulty chewing
Difficulty swallowing
General joint pain and stiffness
Patchy violet to dark red rash across back, shoulders,
and neck
Pink patches on the knuckles
Rashes on the face
Unintentional weight loss
Diagnosis:
Diagnosis is mostly based on the history of symptoms,
blood tests and imaging tests. An MRI may show inflammation
and fibrosis as well as other abnormalities of the
muscle fibers.
A Chest x-ray may also show signs of interstitial
lung disease. Another test, called Electromyography,
may be performed to determine the electrical activity
of the muscles, too.
Blood test results may show:
Elevated Creatine Kinase (CK)
Elevated Aldolase
Positive Anti-Nuclear Antibody (ANA)
Elevated Lactate Dehydrogenase (LDH)
Elevated Aspartate Transaminase (AST)
Muscle biopsies may be taken to confirm the diagnosis.
Treatment:
Treatment is aimed at reducing the inflammation and
suppressing the immune system. Medications commonly
used to treat Dermatomyositis include Corticosteroids,
anti-malarial medications such as Hydroxychloroquine,
immunosuppressive therapy such as Methotrexate and
other immunosuppressant medications.
In severe cases, Intravenous Immunoglobulin (IVIg)
therapy may be used, too. Since Dermatomyositis causes
pain, physicians may also prescribe pain medication
to help cope with the chronic pain associated with
Dermatomyositis.
If a tumor is the cause of Dermatomyositis, symptoms
usually improve when the tumor is removed.
Prognosis:
With effective treatment, Dermatomyositis has the
possibility of going into complete remission. Children
typically do better, and in many cases DM goes away
on it's own. It is important that treatment for Dermatomyositis
is started as soon as possible to reduce the chances
of more severe conditions and complications.
|
