1. School of Allied Health & College of Applied Sciences and Arts
DERMATOMYOSITIS
Sandi Watts, MHA, R.T. (R)
School of Allied Health & College of Applied Sciences and Arts
A rare inflammatory condition causing rashes on the skin and weakness of the skeletal muscles
AGE/GENDER
Children aged between 5 and 15 years of age
Adults aged 40 to 60 years of age
Affects females more than males 2:1
DERMATOMYOSITIS
Dermatomyositis can occur in adults between the ages of 40 to 70, but can also develop in children. There is no cure for this disease but there is medications, therapies and self-care that can reduce pain, increase muscle strength and relieve skin rashes. Dermatomyositis invades the muscles and skin through the blood vessels and causes inflammation that will in turn damage the muscles and skin. Symptoms of this disease can include redness of skin in various areas of the body including but not limited to the eyelids, arms, shoulders, hands, chest and back. The area of redness can also vary in size and shape. There is muscle pain and weakness in the areas of skin erythema. Individuals with Dermatomyositis can also experience fatigue and weight loss. Diagnosing this disease include lab testing and imaging procedures. After diagnosis, the patient is informed of how photosensitive their skin is so it is imperative for individuals with Dermatomyositis to stay out of direct sun light, or wear broad-spectrum sunscreens and clothing that is photo protective. Treating the muscle disease of Dermatomyositis includes staying active to keep muscles moving. This disease can have complications, which includes cardiac, and lung destruction. Due to complications arising from Dermatomyositis, patients may be encouraged to have a team of physicians working together. With no cure for Dermatomyositis, the disease is monitored closely including assessment of muscle strength and examination of the skin.
HOW IS THIS DIAGNOSED?
Blood tests: can indicated muscle damage and autoantibodies
Chest X-ray: can show lung damage
Electromyography: measures electrical activity in muscles
MRI: provides cross sectional images of muscles, can assess inflammation.
SYMPTOMS
Skin changes. Rash develops on:
chest
back
knees
elbows
face
eyelids
Muscle weakness in the areas of:
hips
thighs
shoulders
upper arms
neck.
Muscle pain
Joint inflammation
Fatigue
Weight loss
Lung problems
TREATMENT/MEDICATIONS
Corticosteroids such as Prednisone: controls symptoms quickly
Corticosteroid-sparing agents: used to decrease dose and side effects of corticosteroids
Rituxan: used if initial medications do not work
Sunscreens: to protect rash on skin
Muscles typically affected by PM/DM. Image courtesy of the Muscular Dystrophy Association.
REFERENCES
Femia, Alisa N., Callen, Jeffrey P., Vleugels, Ruth Ann (2017) Dermatomyositis Treatment & Management. Medscape, Retrieved from
Harmon, Angela (2017) Dermatomyositis. Salem Press Encyclopedia of Health, Item:
Shiel, William c. Jr. (Reviewed 2016) Polymyositis and Dermatomyositis. Medicinenet.com, Retrieved from
Mayo Clinic Staff ( ) Dermatomyositis. Mayo Foundation for Medical Education and Research, Retrieved from
What is Dermatomyositis? Myositis Support and Understanding, Retrieved from
Case courtesy of Radswiki, Radiopaedia.org, rID: 11355
MANAGEMENT - PROGNOSIS
Well balanced diet
Stay active with exercise
Take protective measures when in the sun
Continue medications when needed
May have remission periods
Annual physical exams
May need to incorporate a “team” of physicians to help manage disease
Case courtesy of Radswiki, Radiopaedia.org, rID: 11355
COMPLICATIONS
Calcium deposits in muscles, skin, connective tissue (Calcinosis)
Increased risk of falling
Bumps over knuckles, elbows, knees (Gottron’ s Sign)
Increased risk of infection
Interstitial lung disease
Cardiovascular disease
THERE IS NO CURE AT THIS TIME