Dermatomyositis – Causes, Diagnosis and Treatment

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Dermatomyositis is an inflammatory disease. Its occurrence is rare in nature. Muscle weakness and unique skin rash mark this rare health condition. It can also cause inflammatory myopathy.  

It is more common in females than males. It can affect adults and children.

Currently, there is no cure for Dermatomyositis.  

However, there are treatments to manage the symptoms that can help skin rashes and improve muscle strength.  

How can we identify Dermatomyositis?

The signs and symptoms of Dermatomyositis develop gradually.

Usually, symptoms are of two types which affect the skin and the muscles.  

The symptoms of Dermatomyositis appear suddenly. Usually, the first symptom is a unique skin rash that forms on  

  • The face  
  • Eyelids
  • Chest
  • Nails  
  • Arms and  
  • Elbows

This rash is patchy. Generally, it is a bluish colour patch.  

Such rashes on the chest are known as shawl sign as it resembles a shawl.  

Mechanics hand is the name given to the rashes that are found in hand. It makes the skin appear rough. If these rashes are found on hands, then it may also make them look dirty.

These rashes can be itchy and painful. They are often considered the first sign of Dermatomyositis.

A person may also have muscle weakness if they are affected with Dermatomyositis. Muscle weakness gets worse over time.  

Usually, the muscle weakness starts in the neck, arms or abdomen and later gets severe.  

Other muscular symptoms a person may exhibit when they have Dermatomyositis are:

  • Muscle tenderness
  • Problems in the food pipe  
  • Lung problems  
  • Calcium deposits under the skin
  • Fatigue  
  • Rapid weight loss and  
  • Fever

Dermatomyositis may cause the body to exhibit few symptoms. Amyopathic Dermatomyositis is a type of Dermatomyositis that causes skin rashes but not muscle weakness.  

What are the causes of Dermatomyositis?

The exact cause of Dermatomyositis is still unknown, but there are many similarities to such autoimmune diseases.  Autoimmune diseases occur when the body’s immune system, including the disease-fighting cells, lacks antibodies and attack healthy cells. When the immune system in the body is compromised, it may contribute to getting another disease.  

For example, when a person has cancer, it may compromise the immune system and lead to the development of Dermatomyositis.  

Dermatomyositis Is mostly related to an underlying health condition. Paraneoplastic Dermatomyositis is when the disease is associated with a tumour. Such autoimmune diseases of our body mistakingly attack the body’s tissues.  

Both environmental and genetic factors play an important role. Lifestyle choices like smoking, sun exposure and medications also contribute to such autoimmune disorders.  

What are the risk factors associated with Dermatomyositis?

Anyone, irrespective of their age, can develop Dermatomyositis. However, it is commonly found in adults between 40 and 65 and in children between the ages of 5 and 17.  

This disease affects women more than men.  

It is also important to understand that Dermatomyositis might cause other health complications and puts a person at higher risk of developing diseases like,

Lung disease

Interstitial lung disease can occur when there is Dermatomyositis. This disease refers to a group of disorders that can cause damage to lung tissues.

It makes the lungs elastic and stiff. As a result of which, the body may exhibit symptoms like dry cough or shortness of breath.  

Cardiovascular diseases

Dermatomyositis may cause muscle inflammation. This inflammation can also happen to the heart muscles resulting in various heart problems.  

It will eventually lead to congestive heart failure and heart arrhythmia.  

Cancer

Dermatomyositis in adults has been directly linked to increased chances of developing cancer. Given the situation, women are more prone to develop Ovarian cancer.  

Connective tissue diseases  

Health conditions like a lump, Rheumatoid arthritis, Scleroderma, and other connective tissue diseases may occur with Dermatomyositis.  

Raynaud’s phenomenon  

In Raynaud’s phenomenon, the body, when exposed to cold temperature, causes the fingers, cheeks, nose, ears and toes to turn pale.  

How is Dermatomyositis diagnosed?

A doctor will examine a person to check for symptoms and medical history and perform a physical examination to check for Dermatomyositis.  

Dermatomyositis is identified with the help of symptoms as it is visible to the eyes. This is possible because autoimmune rashes are associated with the health condition.  

A doctor will ask a person to:

  • Perform an MRI scan to look for abnormal muscles
  • Perform electromyography to record electrical impulses controlling the muscles
  • Muscle biopsy to look for inflammation
  • Blood analysis to check the level of muscle enzymes
  • Skin biopsy to look for changes in the skin.

A doctor will also recommend a blood test so that it reveals an elevated level of muscle enzymes that indicate muscle damage.

After all the essential checks are done, a doctor would commence the treatment for the disease.  

How to treat Dermatomyositis?  

As mentioned above, there is no permanent cure for Dermatomyositis. When a person is treated, it can only improve the condition of muscles and skin and contain the symptoms.  

Some of the common treatments or medication, surgery and physical therapies.  

Corticosteroids  

Corticosteroid medications are the most preferred way of treating Dermatomyositis.  

These medications can be orally consumed or can be applied to the skin. Corticosteroids lower the response of the body’s immune system, thus reducing the inflammation caused by the antibodies attacking the cells.  

Children with this Dermatomyositis condition may witness the symptoms subside fully after treating it with corticosteroids.  

This process is called remission. Remission might be long-lasting; it may even leave a permanent effect.  

But there are certain limitations to corticosteroids. It should not be consumed in higher doses for longer periods as it may cause potential side effects.  

Generally, during the treatment course, a doctor will start the cycle with high doses and then lower it over time.  

A doctor even recommends a person to completely stop taking corticosteroids if the symptoms reduce and stop occurring.  

However, a doctor may prescribe other medications to suppress the immune system.  

Corticosteroid-sparing medication is used to reduce the side effects of corticosteroids.  

Some of the commonly used corticosteroid-sparing agents are azathioprine, mycophenolate and methotrexate.  

Intravenous immunoglobulin

Intravenous immunoglobulins use healthy antibodies to block antibodies that attack the immune system.  

Intravenous immunoglobulins contain antibodies that are collected from healthy blood donated by people. These antibodies enter the body when it is given to a person through an IV.  

Internist

An internist Is a doctor who deals with internal medicine. They specialise in internal organs and various systems of the body.   

They give preventive measures and treat health conditions which include skin rashes and infections.  However, an internist can only treat an adult. Another point to consider is that they are not surgeons, but they provide treatment for internal organs.

Rheumatologist

Rheumatology is a speciality that deals with internal medicine and paediatrics. It deals with soft tissues, autoimmune disorders, bone joints and others connected to tissues.

A rheumatologist is a doctor who specialises in treating inflammatory diseases.   

They treat various health conditions like muscle injuries, autoimmune disorders and tendon problems.  

Immunologist

Immunologists are commonly referred to as allergists. They are physicians specialising in diagnosing and treating allergies and other immunology disorders.  

There is a slight difference between immunologists and rheumatologists. An immunologist treats patients with immunologic conditions, and a rheumatologist treats patients with autoimmune diseases and conditions related to muscle and skeleton.  

Physical therapy

Physical therapy will improve and preserve muscle strength reducing muscle loss.  

A physical therapist will evaluate and monitor a patient’s progress as they help injured people to improve their movement and manage their pain.

Speech therapy

If the food pipe is affected and the muscles are disturbed, speech therapy can help compensate for those changes.  

Dietician

When there is difficulty in chewing and swallowing, the diet of the person must be altered, and therefore there is a need for a dietician to guide them.  

Home remedies

Proper medical treatment can contain the symptoms of Dermatomyositis. However, people can make small lifestyle changes and home remedies like using sunscreen and wearing protective clothing to prevent skin burns.  

Exercises

A physiotherapist will come in handy if a person needs to improve their strength. Dermatomyositis causes muscle weakness; following a schedule of exercising can help improve muscle weakness.

Orthotics  

When the symptoms of Dermatomyositis are severe and muscle weakness is more, there is a need for orthotics.  

It is a device or a set of devices that provide support for the body that has been weakened by injury, diseases or disorders.  

These devices help with the support and movement of the affected part of the body.  

Rest

The body requires adequate rest in order to recover from the disease. Diet and recovery play a crucial role in building the health of a person.  

To efficiently manage the symptoms of Dermatomyositis, it is important to rest adequately.  

Educating about illness

Knowing as much as possible about Dermatomyositis or other autoimmune diseases and talking to people with similar health conditions can give an abundance of information and open new perspectives on how people cope.  

Following the treatment plan  

Involving a doctor and other medical experts in the case is important. Following a treatment plan is essential, which keeps the doctor updated on the symptoms for further treatment.  

Recognise your feelings

It is common for people to be frustrated and angry when they deal with Dermatomyositis. Fear and isolation are common; it is important for the family members to stay close to the affected people.  

Acknowledging the emotions rightly is essential. Realising that nobody is going to judge anyone based on their health condition and finding support groups will be helpful.

To sum up

Dermatomyositis is a rare disease, and only a small amount of people have recovered.  

The exact cause of this health condition is unknown, just like other autoimmune disorders, and they have no treatment.  

A healthy lifestyle and support from other people can help a person with Dermatomyositis.  

Making a few lifestyle changes, including regular exercise and medication, can reduce inflammation and other symptoms.  

Consulting a doctor and following a medical plan is mandatory for people with Dermatomyositis.  

FAQ

1.How serious is Dermatomyositis?  

Dermatomyositis is a serious and other health condition. When the disease is progressed, it leads to further complications and may also be life-threatening.

2.What is the life expectancy of someone with Dermatomyositis?  

Dermatomyositis is a serious health condition that can reduce a person’s lifespan. The health condition had survival rates of 82% in the first year 73% in the second year, and 7% and the fifth year.  

3.What does Dermatomyositis look like?   

  Dermatomyositis causes the body a distinct rash on the skin, which spreads across the face, neck, chest and hands.  

4.What organs does Dermatomyositis affect?

Dermatomyositis affects muscles and the skin. It predominantly affects the muscles in the shoulder, upper arms, hips, heart, and neck and also causes inflation.  

5.Is there a cure coming soon for Dermatomyositis?  

  No. There is no cure for Dermatomyositis, but proper treatment can manage the symptoms and improve skin condition and muscle strength.  

6.Does Dermatomyositis affect the eyes?

Usually, this health condition doesn’t affect the eyes. It is uncommon. But in a rare phenomenon, the rash tends to affect the eyelids and cause problems.  

7.Does Dermatomyositis make you itch?

The most commonly exhibited sign of Dermatomyositis is skin rashes. These rashes are itchy and painful.  
However, treatment can be given to reduce the effects of the symptoms.

8.What virus causes Dermatomyositis?

In most cases, there is no clear cause for the development of this health condition. Any virus might be a trigger for autoimmune disease.  

9.Does exercise help Dermatomyositis?

Performing exercises can improve mitochondrial functions and promote muscle growth. It also reduces inflammation. Consulting a physician for specialised exercises is recommended.


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The Information including but not limited to text, graphics, images and other material contained on this blog are intended for education and awareness only. No material on this blog is intended to be a substitute for professional medical help including diagnosis or treatment. It is always advisable to consult medical professional before relying on the content. Neither the Author nor Star Health and Allied Insurance Co. Ltd accepts any responsibility for any potential risk to any visitor/reader.

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