Also referred to as heliotrope rash, dermatomyositis is an uncommon inflammatory disorder wherein patients suffer from distinctive rashes on skin as well as muscular weakness. In the medical world, it is classified as a chronic inflammatory myopathy and regarded as 1 of three such conditions.
Dermatomyositis can affect both adults and children. However, children between 5 and 15 years old and adults between 45 and 65 years old are more prone to developing dermatomyositis. Women are more vulnerable to the condition as opposed to men.
Individuals affected by dermatomyositis may experience sudden improvement of symptoms for some time. However, such remission is typically for a limited time period. Different treatment methods can help eliminate the skin rashes and also aid in recovery of muscle strength and function.
Symptoms of dermatomyositis
Some of the common signs and symptoms of dermatomyositis are mentioned below:
- Appearance of reddish, brownish, or violet colored anomalies on the skin. They usually affect the face and eyelids, and can sometimes occur on the nails, knuckles, elbows, knees, and the chest and back. Thisdistinctive skin rash is often the first symptom of dermatomyositis. It tends to be patchy along with bluish-purple stain marks.
- There may be progressive weakening of the muscles, especially of those occurring near the trunk, like the thighs, shoulders, hips, neck, and upper arms. The weakness occurs symmetrically, tends to aggravate gradually, and can affect both the left and right sides of the body.
- Patients may experience noticeable exhaustion, fever, and weight loss.
- Difficulties in swallowing.
- The muscles may also elicit pain and tenderness.
- Pulmonary abnormalities may be present.
- Hardened calcium may buildup under the skin, especially in affected children.
- Children with dermatomyositis are also more likely to develop gastrointestinal ulceration and Intestinal punctures.
Complications of dermatomyositis
Complications associated with skin defects: It includes the following:
- The exacerbation of dermatomyositis and its later stages involve accumulation of calcium in the muscles, skin, and connective tissues. Such calcium deposits are more common and occur more quickly in affected children.
- Dermatomyositis skin rashes are also vulnerable to infections. They particularly pose increased threat to infections of the respiratory and digestive tracts.
Complications associated with muscular weakness: It includes the following:
- Weakness of the esophageal muscles can result in dysphagia or swallowing problems. This can increase the risk to malnutrition and eventual loss of weight.
- Swallowing anomalies can result in occurrence of aspiration pneumonia. Affected people may aspirate food, liquids, or saliva into the lungs leading to pulmonary problems.
- Weakness of the varied muscles near the trunk and accompanying eating anomalies can lead to bleeding, ulcer development, and other gastrointestinal disturbances.
- Dermatomyositis cases accompanied by weakness of the chest muscles may cause respiratory problems like shortness of breath.
Elevated risk to varied diseases: Dermatomyositis increases a patient’s vulnerability towards developing the below listed disorders and health problems:
- Expectant women with dermatomyositis may experience pregnancy complications. They are at increased risk to premature delivery or stillbirth. This is not the case if the inflammatory condition is in remission.
- Increased susceptibility to different kinds of cancers, particularly cancers of the cervix, lungs, breasts, ovaries, and the digestive tract.
- Increased vulnerability towards myocarditis or inflammation of the heart muscles and other cardiovascular diseases. Some patients may also suffer from congestive heart failure and/or cardiac arrhythmia.
- Dermatomyositis may aid the development of interstitial lung disease. It is a group of disorders identified by scarring of lung tissue or fibrosis, which in turn leads to stiffness or decreased elasticity of the lungs. The condition can result in a dry cough and shortness of breath.
- Patients are also vulnerable towards developing varied connective tissue disorders like lupus, rheumatoid arthritis, scleroderma, and Sjogren’s syndrome.
- Increased susceptibility to developing Raynaud’s phenomenon, a condition wherein patients suffer from discoloration of body extremities like the fingers, toes, cheeks, nose, and ears, etc. after contact with cold weather.
Causes of dermatomyositis
Doctors are not aware of the exact cause of dermatomyositis. The condition is however slightly similar to autoimmune diseases that cause adverse immune system reactions.
All of us know that the immune system performs the function of guarding the body against attacks by bacteria, viruses, and other pathogens. However, in dermatomyositis patients the immune system produces antibodies to attack the healthy body tissues, especially the small blood vessels present in muscle tissues.Subsequent inflammation causes increased number of inflammatory cells in the blood vessels, which eventually leads to muscle fiber degradation.
Treatment of dermatomyositis
Dermatomyositis has no known cure. Treatment is focused on improving the symptoms and preventing complications.
- Dermatomyositis skin rashes are treated with biological medications such as TNF inhibitors or Rituximab.
- The adverse actions of the immune system are suppressed with corticosteroid medicines. Doctors may opt for immunosuppressive therapies like intravenous immunoglobulin if corticosteroid therapy does not yield results.
- Muscle flexibility and power can be regained with physical therapies.
- Pain can be alleviated with the use of pain-killer medications.