Dermatomyositis is an infrequent inflammatory disease, which manifests in form of weak muscles and distinct skin rash. It affects both children and adults. Among adults, dermatomyositis is mostly witnessed in the late ages of about 40 to 60 years. In children, the disease affects kids of about 5 to 15 years. It is common in females than in males. While there is no cure for this condition, there occurs periods of remission when the symptoms tend to improve. Treatment is aimed at clearing the skin rash and helping one to regain their muscle strength and function.
Dermatomyositis – Rash and Other Symptoms
Many people with this condition will have symptoms such as skin changes. The skin rash turns violet in color or dusky red, and it appears mainly on the face or the eyelids. It also affects the areas around the knuckles, nails, knees, elbows, back, and chest. The rash is often the first you see in people with dermatomyositis, and it occurs in form of patchy bluish-purple discoloration.
Another sign is muscle weakness where there is progressive weakness of muscles especially those close to trunk such as the thighs, hips, shoulders, neck, and upper arms. The weakness may be experienced in both right and left side of body and at times, it tends to get worse. People who have weak muscles and an unexplained rash should consider seeking help of a doctor for further examination.
Causes of dermatomyositis
It is not clearly understood what causes dermatomyositis but there are shared characteristics of this condition with other autoimmune disorders where the immune system attacks its own body tissues, mistakenly. In dermatomyositis, the small blood vessels found in muscular tissue are affected. The inflammatory cells tend to enfold these small blood vessels, which causes the degeneration of muscle fibers causing the muscles weakness.
There may be present complications in patients with dermatomyositis and they include difficulty swallowing, aspiration pneumonia, breathing problems, and calcium deposits. When the muscles around the esophagus are affected by this skin condition, one may have problem with swallowing, a condition known as dysphagia. This could cause other problems such as malnutrition and weight loss.
Moreover, the difficult in swallowing may cause one to breath liquids and foods or saliva into their lungs which causes aspiration pneumonia. When the chest muscles are affected, one is likely to have troubles with breathing including shortness of breath.
There may also be calcium deposits in muscles, connective tissues, and skin as this condition advances. Such deposits of calcium are more witnessed in children who have dermatomyositis.
People with dermatomyositis may be put at risk of suffering from other conditions such as rheumatoid arthritis, lupus, Sjogren’s syndrome, and scleroderma— all these are connective tissue diseases.
People with dermatomyositis may also have a higher risk of developing Raynaud’s phenomenon where the fingers, cheeks, nose, toes, and ears turn pale when they are exposed to cold temperatures. Lung disease and cancer are other conditions, which may occur when a person has dermatomyositis.
In examining and diagnosing dermatomyositis, a doctor may suggest different test procedures including blood analysis and imaging. A blood test can indicate whether there are elevated levels of enzymes in muscles such as aldolase or creatine kinase. When there are increased levels of these enzymes, it could indicate there is muscle damage.
A blood test may also help in detecting the autoantibodies that are linked to symptoms of dermatomyositis. This helps determine which medications can be provided. X-rays can be performed to determine whether there is lung damage as this can occur in patients with dermatomyositis.
There is no cure for this condition though treatment can be done to help in improving the skin and muscle function. It is important that treatment be started earlier in order to prevent complications. In addition to that, because of the many conditions involved, there may be no single approach in treatment and doctors may have to tailored the treatment based on the symptoms a person develops and how they respond to treatment.
Some of the medications that may be used are such as corticosteroids, Rituximab, antimalaria medicines, and corticosteroid sparing agents. In treating the symptoms and complications, other therapies may be used such as physical therapy to help in strengthening and making the muscles to be flexible.
Speech therapy may needed to help is compensate for the changes in speech which are caused by weakening of muscles of the oesophagus. Considering that dermatomyositis can cause problems with chewing and swallowing, a dietician may help you learn how to prepare foods that are easy to eat.
At times, surgery and intravenous immunoglobulin may be applied in treatment. The surgery is aimed at removing calcium deposits that have become painful or preventing skin infection. The intravenous immunoglobulin helps block the damaging antibodies, which tend to attack health muscle tissues or the skin in patients with dermatomyositis.